Measuring feasibility: complex questions need complex tools

We sought to assess the feasibility of mainstreaming balanced energy protein supplementation, a maternal nutrition intervention, into Bangladesh’s routine antenatal care system in tandem with an ongoing effectiveness trial in northwestern Bangladesh. Feasibility is an implementation science outcome...

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Main Authors: Malabika Sarker, Daniela C Rodríguez, Anna Kalbarczyk, Parul Christian, Muhammed Nazmul Islam, Mary de Boer, Andrew Thorne Lyman
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/10/6/e017331.full
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author Malabika Sarker
Daniela C Rodríguez
Anna Kalbarczyk
Parul Christian
Muhammed Nazmul Islam
Mary de Boer
Andrew Thorne Lyman
author_facet Malabika Sarker
Daniela C Rodríguez
Anna Kalbarczyk
Parul Christian
Muhammed Nazmul Islam
Mary de Boer
Andrew Thorne Lyman
author_sort Malabika Sarker
collection DOAJ
description We sought to assess the feasibility of mainstreaming balanced energy protein supplementation, a maternal nutrition intervention, into Bangladesh’s routine antenatal care system in tandem with an ongoing effectiveness trial in northwestern Bangladesh. Feasibility is an implementation science outcome defined as the extent to which a new intervention can be implemented successfully in a given context. We found feasibility difficult to measure using existing Anglophone quantitative tools translated into Bangla and identified particular challenges with using Likert scales. We also found it challenging to measure feasibility early in implementation, as recommended in the implementation science literature, due to potential respondents’ unfamiliarity with the intervention and what implementation would look like. To address these issues, we explored alternative assessment methods, such as focus groups and workshops. These formats presented additional difficulties, including identifying the correct participants and moderating participant power dynamics. In conclusion, we question whether existing feasibility assessment tools, developed in English, are suitable for use in non-Anglophone contexts as well as whether Likert scales are appropriate for use in low-income and middle-income countries more broadly. We also question current recommendations on the timing of feasibility assessments. We feel that—particularly with new, difficult-to-conceptualise interventions—feasibility must be assessed later in implementation or only after providing detailed explanations of the intervention to respondents.
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spelling doaj-art-e8817e4a671247d4bcb824fee1b6b18e2025-08-20T02:03:08ZengBMJ Publishing GroupBMJ Global Health2059-79082025-06-0110610.1136/bmjgh-2024-017331Measuring feasibility: complex questions need complex toolsMalabika Sarker0Daniela C Rodríguez1Anna Kalbarczyk2Parul Christian3Muhammed Nazmul Islam4Mary de Boer5Andrew Thorne Lyman6Behavioral and Social Sciences, Brown University, Providence, Rhode Island, USAInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USABRAC University James P Grant School of Public Health, Dhaka, BangladeshInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAWe sought to assess the feasibility of mainstreaming balanced energy protein supplementation, a maternal nutrition intervention, into Bangladesh’s routine antenatal care system in tandem with an ongoing effectiveness trial in northwestern Bangladesh. Feasibility is an implementation science outcome defined as the extent to which a new intervention can be implemented successfully in a given context. We found feasibility difficult to measure using existing Anglophone quantitative tools translated into Bangla and identified particular challenges with using Likert scales. We also found it challenging to measure feasibility early in implementation, as recommended in the implementation science literature, due to potential respondents’ unfamiliarity with the intervention and what implementation would look like. To address these issues, we explored alternative assessment methods, such as focus groups and workshops. These formats presented additional difficulties, including identifying the correct participants and moderating participant power dynamics. In conclusion, we question whether existing feasibility assessment tools, developed in English, are suitable for use in non-Anglophone contexts as well as whether Likert scales are appropriate for use in low-income and middle-income countries more broadly. We also question current recommendations on the timing of feasibility assessments. We feel that—particularly with new, difficult-to-conceptualise interventions—feasibility must be assessed later in implementation or only after providing detailed explanations of the intervention to respondents.https://gh.bmj.com/content/10/6/e017331.full
spellingShingle Malabika Sarker
Daniela C Rodríguez
Anna Kalbarczyk
Parul Christian
Muhammed Nazmul Islam
Mary de Boer
Andrew Thorne Lyman
Measuring feasibility: complex questions need complex tools
BMJ Global Health
title Measuring feasibility: complex questions need complex tools
title_full Measuring feasibility: complex questions need complex tools
title_fullStr Measuring feasibility: complex questions need complex tools
title_full_unstemmed Measuring feasibility: complex questions need complex tools
title_short Measuring feasibility: complex questions need complex tools
title_sort measuring feasibility complex questions need complex tools
url https://gh.bmj.com/content/10/6/e017331.full
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