Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study
Objective We aimed to increase the understanding of the scaling of de-implementation strategies by identifying the determinants of the process and developing a determinant framework.Design and methods This study has a mixed-methods design. First, we performed an integrative review to build a literat...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e062902.full |
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| _version_ | 1825208822542630912 |
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| author | Gert P Westert Rudolf B Kool Simone A van Dulmen Patrick P T Jeurissen Danielle Kroon |
| author_facet | Gert P Westert Rudolf B Kool Simone A van Dulmen Patrick P T Jeurissen Danielle Kroon |
| author_sort | Gert P Westert |
| collection | DOAJ |
| description | Objective We aimed to increase the understanding of the scaling of de-implementation strategies by identifying the determinants of the process and developing a determinant framework.Design and methods This study has a mixed-methods design. First, we performed an integrative review to build a literature-based framework describing the determinants of the scaling of healthcare innovations and interventions. PubMed and EMBASE were searched for relevant studies from 1995 to December 2020. We systematically extracted the determinants of the scaling of interventions and developed a literature-based framework. Subsequently, this framework was discussed in four focus groups with national and international de-implementation experts. The literature-based framework was complemented by the findings of the focus group meetings and adapted for the scaling of de-implementation strategies.Results The literature search resulted in 42 articles that discussed the determinants of the scaling of innovations and interventions. No articles described determinants specifically for de-implementation strategies. During the focus groups, all participants agreed on the relevance of the extracted determinants for the scaling of de-implementation strategies. The experts emphasised that while the determinants are relevant for various countries, the implications differ due to different contexts, cultures and histories. The analyses of the focus groups resulted in additional topics and determinants, namely, medical training, professional networks, interests of stakeholders, clinical guidelines and patients’ perspectives. The results of the focus group meetings were combined with the literature framework, which together formed the supporting the scaling of de-implementation strategies (SPREAD) framework. The SPREAD framework includes determinants from four domains: (1) scaling plan, (2) external context, (3) de-implementation strategy and (4) adopters.Conclusions The SPREAD framework describes the determinants of the scaling of de-implementation strategies. These determinants are potential targets for various parties to facilitate the scaling of de-implementation strategies. Future research should validate these determinants of the scaling of de-implementation strategies. |
| format | Article |
| id | doaj-art-bc8eb77cf3ac49809e0c480e3f68cb0f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-bc8eb77cf3ac49809e0c480e3f68cb0f2025-02-06T20:30:10ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-062902Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods studyGert P Westert0Rudolf B Kool1Simone A van Dulmen2Patrick P T Jeurissen3Danielle Kroon43 IQ Healthcare, Radboud Institute for Health Sciences, Nijmegen, The NetherlandsIQ Healthcare, Radboudumc, Nijmegen, The NetherlandsIQ Healthcare, Radboudumc, Nijmegen, The NetherlandsIQ Healthcare, Radboudumc, Nijmegen, The NetherlandsIQ Healthcare, Radboudumc, Nijmegen, The NetherlandsObjective We aimed to increase the understanding of the scaling of de-implementation strategies by identifying the determinants of the process and developing a determinant framework.Design and methods This study has a mixed-methods design. First, we performed an integrative review to build a literature-based framework describing the determinants of the scaling of healthcare innovations and interventions. PubMed and EMBASE were searched for relevant studies from 1995 to December 2020. We systematically extracted the determinants of the scaling of interventions and developed a literature-based framework. Subsequently, this framework was discussed in four focus groups with national and international de-implementation experts. The literature-based framework was complemented by the findings of the focus group meetings and adapted for the scaling of de-implementation strategies.Results The literature search resulted in 42 articles that discussed the determinants of the scaling of innovations and interventions. No articles described determinants specifically for de-implementation strategies. During the focus groups, all participants agreed on the relevance of the extracted determinants for the scaling of de-implementation strategies. The experts emphasised that while the determinants are relevant for various countries, the implications differ due to different contexts, cultures and histories. The analyses of the focus groups resulted in additional topics and determinants, namely, medical training, professional networks, interests of stakeholders, clinical guidelines and patients’ perspectives. The results of the focus group meetings were combined with the literature framework, which together formed the supporting the scaling of de-implementation strategies (SPREAD) framework. The SPREAD framework includes determinants from four domains: (1) scaling plan, (2) external context, (3) de-implementation strategy and (4) adopters.Conclusions The SPREAD framework describes the determinants of the scaling of de-implementation strategies. These determinants are potential targets for various parties to facilitate the scaling of de-implementation strategies. Future research should validate these determinants of the scaling of de-implementation strategies.https://bmjopen.bmj.com/content/12/11/e062902.full |
| spellingShingle | Gert P Westert Rudolf B Kool Simone A van Dulmen Patrick P T Jeurissen Danielle Kroon Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study BMJ Open |
| title | Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study |
| title_full | Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study |
| title_fullStr | Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study |
| title_full_unstemmed | Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study |
| title_short | Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study |
| title_sort | development of the spread framework to support the scaling of de implementation strategies a mixed methods study |
| url | https://bmjopen.bmj.com/content/12/11/e062902.full |
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