Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide
Introduction Scaling up interventions targeting non-communicable diseases (NCDs) is a global health priority, and implementation research can contribute to that effort. In 2019, the Global Alliance for Chronic Diseases funded 27 implementation research studies to improve evidence for scaling up inte...
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BMJ Publishing Group
2024-04-01
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| Series: | BMJ Public Health |
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| author | Josefien van Olmen Peter Delobelle Meena Daivadanam Hassan Haghparast-Bidgoli Maria Lazo-Porras J Jaime Miranda Yuan Li Rohina Joshi Amanda G Thrift Rajesh Vedanthan Gina Agarwal Mark D Huffman Kerstin Klipstein-Grobusch Naomi Levitt Dike Ojji Feng J He Kamran Siddiqi Pascal Geldsetzer Puhong Zhang Milena Soriano Marcolino Lal B Rawal Brian Oldenburg Helena Teede Josephine Birungi Edwin Wouters Abha Shrestha Ari Probandari Mayowa Owolabi Vilma Irazola Andrea Beratarrechea Keiko Nakamura Gindo Tampubolon Zulma Ortiz Violet Naanyu Jaap Koot Anusha Ramani-Chander Stephen Sherwood Monika Martens Gade Waqa Maria Eugenia Esandi Sujarwoto Sujarwoto Laura Antonietti Jan-Walter De Neve Sayoki G Mfinanga Antonio Luiz Pinho Ribeiro |
| author_facet | Josefien van Olmen Peter Delobelle Meena Daivadanam Hassan Haghparast-Bidgoli Maria Lazo-Porras J Jaime Miranda Yuan Li Rohina Joshi Amanda G Thrift Rajesh Vedanthan Gina Agarwal Mark D Huffman Kerstin Klipstein-Grobusch Naomi Levitt Dike Ojji Feng J He Kamran Siddiqi Pascal Geldsetzer Puhong Zhang Milena Soriano Marcolino Lal B Rawal Brian Oldenburg Helena Teede Josephine Birungi Edwin Wouters Abha Shrestha Ari Probandari Mayowa Owolabi Vilma Irazola Andrea Beratarrechea Keiko Nakamura Gindo Tampubolon Zulma Ortiz Violet Naanyu Jaap Koot Anusha Ramani-Chander Stephen Sherwood Monika Martens Gade Waqa Maria Eugenia Esandi Sujarwoto Sujarwoto Laura Antonietti Jan-Walter De Neve Sayoki G Mfinanga Antonio Luiz Pinho Ribeiro |
| collection | DOAJ |
| description | Introduction Scaling up interventions targeting non-communicable diseases (NCDs) is a global health priority, and implementation research can contribute to that effort. In 2019, the Global Alliance for Chronic Diseases funded 27 implementation research studies to improve evidence for scaling up interventions targeting prevention and/or control of hypertension and/or diabetes in low-resource settings. We examined these studies to improve the understanding of the implementation factors, including challenges and facilitators, that influence the early implementation phase of scale-up research projects targeting NCDs.Methods This qualitative study was undertaken between August 2020 and July 2021. 43 semi-structured interviews were conducted with project investigators, implementers and policymakers, across 19 diverse scale-up projects, being implemented in 20 countries. The transcripts were inductively, open-coded using thematic analysis. Generated themes were mapped systematically to four out of five domain categorisations of the Consolidated Framework for Implementation Research (CFIR); the innovation domain fell outside the scope of this study.Results Highlighted findings using CFIR are: (i) outer setting: influence of politics, lack of coordination between government departments and differing agendas towards NCDs hindered implementation while reliable and trustworthy government connections proved useful; (ii) inner setting: commitment of resources for implementation was a challenge while research capacity, work culture and trustworthy networks facilitated implementation; (iii) individuals: high-level stakeholder support and leadership was essential; (iv) process: extensive time and efforts required for stakeholder engagement towards local contextualisation was challenging, while collaborating, joint reflection, effective communication and adaptation facilitated. COVID-19 provided both challenges and opportunities and these varied depending on the intervention characteristics and study objectives.Conclusion Researchers supporting the scale-up of complex interventions targeting NCDs need to leverage on existing trusting relationships and foster equitable stakeholder partnerships through research. Interpersonal skills and good communication are essential complements to research expertise and must be considered during capacity building. |
| format | Article |
| id | doaj-art-681331fe62284e468139be0fc08ffc6f |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-681331fe62284e468139be0fc08ffc6f2025-01-29T01:45:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-04-012110.1136/bmjph-2023-000710Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide 0Josefien van Olmen1Peter Delobelle2Meena Daivadanam3Hassan Haghparast-BidgoliMaria Lazo-PorrasJ Jaime Miranda4Yuan Li5Rohina Joshi6Amanda G Thrift7Rajesh Vedanthan8Gina Agarwal9Mark D Huffman10Kerstin Klipstein-Grobusch11Naomi Levitt12Dike OjjiFeng J HeKamran Siddiqi13Pascal GeldsetzerPuhong ZhangMilena Soriano Marcolino14Lal B RawalBrian OldenburgHelena Teede15Josephine BirungiEdwin Wouters16Abha Shrestha17Ari Probandari18Mayowa OwolabiVilma IrazolaAndrea BeratarrecheaKeiko Nakamura19Gindo TampubolonZulma OrtizViolet NaanyuJaap KootAnusha Ramani-Chander20Stephen Sherwood21Monika MartensGade WaqaMaria Eugenia EsandiSujarwoto SujarwotoLaura AntoniettiJan-Walter De NeveSayoki G MfinangaAntonio Luiz Pinho RibeiroUK Heat Illness Advisory Group, London, UKUniversity of Antwerp, Antwerpen, Belgium5 Chronic Disease Initiative of Africa, University of Cape Town, Rondebosch, South AfricaGlobal Health and Migration Unit, Department of Women`s and Children`s Health, Uppsala University, Uppsala, Sweden8 CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru1 Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China7 School of Population Health, University of New South Wales (UNSW), Sydney, New South Wales, AustraliaDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, AustraliaPopulation Health, New York University Grossman School of Medicine, New York, New York, USADepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaCentre for Chronic Disease Control, New Delhi, IndiaJulius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands6 Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa1 University of York, York, UKDepartament of Internal Medicine, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSchool of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia4 Department of Sociology, Centre for Population, Family & Health, University of Antwerp, Antwerpen, BelgiumDepartment of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Province 3, NepalCenter for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, IndonesiaDepartment of Global Health Entreprenership, Institute of Science Tokyo (Science Tokyo), Tokyo, Japan1 Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia10 Fundacion Ekorural, Quito, EcuadorIntroduction Scaling up interventions targeting non-communicable diseases (NCDs) is a global health priority, and implementation research can contribute to that effort. In 2019, the Global Alliance for Chronic Diseases funded 27 implementation research studies to improve evidence for scaling up interventions targeting prevention and/or control of hypertension and/or diabetes in low-resource settings. We examined these studies to improve the understanding of the implementation factors, including challenges and facilitators, that influence the early implementation phase of scale-up research projects targeting NCDs.Methods This qualitative study was undertaken between August 2020 and July 2021. 43 semi-structured interviews were conducted with project investigators, implementers and policymakers, across 19 diverse scale-up projects, being implemented in 20 countries. The transcripts were inductively, open-coded using thematic analysis. Generated themes were mapped systematically to four out of five domain categorisations of the Consolidated Framework for Implementation Research (CFIR); the innovation domain fell outside the scope of this study.Results Highlighted findings using CFIR are: (i) outer setting: influence of politics, lack of coordination between government departments and differing agendas towards NCDs hindered implementation while reliable and trustworthy government connections proved useful; (ii) inner setting: commitment of resources for implementation was a challenge while research capacity, work culture and trustworthy networks facilitated implementation; (iii) individuals: high-level stakeholder support and leadership was essential; (iv) process: extensive time and efforts required for stakeholder engagement towards local contextualisation was challenging, while collaborating, joint reflection, effective communication and adaptation facilitated. COVID-19 provided both challenges and opportunities and these varied depending on the intervention characteristics and study objectives.Conclusion Researchers supporting the scale-up of complex interventions targeting NCDs need to leverage on existing trusting relationships and foster equitable stakeholder partnerships through research. Interpersonal skills and good communication are essential complements to research expertise and must be considered during capacity building.https://bmjpublichealth.bmj.com/content/2/1/e000710.full |
| spellingShingle | Josefien van Olmen Peter Delobelle Meena Daivadanam Hassan Haghparast-Bidgoli Maria Lazo-Porras J Jaime Miranda Yuan Li Rohina Joshi Amanda G Thrift Rajesh Vedanthan Gina Agarwal Mark D Huffman Kerstin Klipstein-Grobusch Naomi Levitt Dike Ojji Feng J He Kamran Siddiqi Pascal Geldsetzer Puhong Zhang Milena Soriano Marcolino Lal B Rawal Brian Oldenburg Helena Teede Josephine Birungi Edwin Wouters Abha Shrestha Ari Probandari Mayowa Owolabi Vilma Irazola Andrea Beratarrechea Keiko Nakamura Gindo Tampubolon Zulma Ortiz Violet Naanyu Jaap Koot Anusha Ramani-Chander Stephen Sherwood Monika Martens Gade Waqa Maria Eugenia Esandi Sujarwoto Sujarwoto Laura Antonietti Jan-Walter De Neve Sayoki G Mfinanga Antonio Luiz Pinho Ribeiro Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide BMJ Public Health |
| title | Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide |
| title_full | Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide |
| title_fullStr | Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide |
| title_full_unstemmed | Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide |
| title_short | Challenges and enablers for scaling up interventions targeting non-communicable diseases: a qualitative study applying the Consolidated Framework for Implementation Research to 19 research projects worldwide |
| title_sort | challenges and enablers for scaling up interventions targeting non communicable diseases a qualitative study applying the consolidated framework for implementation research to 19 research projects worldwide |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000710.full |
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