Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption.
Many implementation efforts experience interruptions, especially in settings with developing health systems. Approaches for evaluating interruptions are needed to inform re-implementation strategies. We sought to devise an approach for evaluating interruptions by exploring the sustainability of a pr...
| Publicado en: | Global Public Health Vol. 17; no. 9; pp. 1868 - 1883 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Aug/Sep2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=158808271&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 158808271 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17441692 15UG jtl: Global Public Health issn: 17441692 maglogo: N pubinfo: dt: Aug/Sep2022 vid: 17 iid: 9 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 158808271 153529904 158808271 158808271 10.1080/17441692.2021.2003838 158808271 ppf: 1868 ppct: 15 formats: tig: atl: Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption. aug: au: Hennein, Rachel Ggita, Joseph Ssuna, Bashir Shelley, Donna Akiteng, Ann R. Davis, J. Lucian Katamba, Achilles Armstrong-Hough, Mari affil: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda sug: subj: Noncommunicable Diseases Implementation Science Tuberculosis Diabetes Mellitus Human Uganda Qualitative Studies Thematic Analysis Self-Efficacy Semi-Structured Interview Public Health Content Analysis Grounded Theory Female Male Female Male ab: Many implementation efforts experience interruptions, especially in settings with developing health systems. Approaches for evaluating interruptions are needed to inform re-implementation strategies. We sought to devise an approach for evaluating interruptions by exploring the sustainability of a programme that implemented diabetes mellitus (DM) screening within tuberculosis clinics in Uganda in 2017. In 2019, we conducted nine interviews with clinic staff and observed clinic visits to determine their views and practices on providing integrated care. We mapped themes to a social ecological model with three levels derived from the Consolidated Framework for Implementation Research (CFIR): outer setting (i.e. community), inner setting (i.e. clinic), and individuals (i.e. clinicians). Respondents explained that DM screening ceased due to disruptions in the national supply chain for glucose test strips, which had cascading effects on clinics and clinicians. Lack of screening supplies in clinics limited clinicians' opportunities to perform DM screening, which contributed to diminished self-efficacy. However, culture, compatibility and clinicians' beliefs about DM screening sustained throughout the interruption. We propose an approach for evaluating interruptions using the CFIR and social ecological model; other programmes can adapt this approach to identify cascading effects of interruptions and target them for re-implementation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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