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了解一项预防原住民老年人跌倒的整群随机对照试验的实施因素和参与者体验:一项过程评估方案。

Understanding implementation factors and participant experiences of a cluster randomised controlled trial to prevent falls among older Aboriginal people: a process evaluation protocol.

作者信息

Macniven Rona, Coombes Julieann, Wilson Roland, Simon Aaron, Mackean Tamara, Hunter Kate, Ma Tracey, Gwynn Josephine, Sherrington Catherine, Tiedemann Anne, Hill Anne-Marie, Delbaere Kim, Lewis Carolyn, Bennett-Brook Keziah, Howie Adam, Stewart Georgia, Shakespeare Madison, Rogers Kris, Ivers Rebecca Q, Clapham Kathleen

机构信息

School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia

Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

Inj Prev. 2021 Jan 5. doi: 10.1136/injuryprev-2020-043980.

Abstract

INTRODUCTION

Process evaluations examining programme implementation are often conducted in conjunction with effectiveness studies. Their inclusion in studies with Aboriginal participants can give an understanding of programme delivery in Aboriginal community contexts. The programme was codesigned with Aboriginal communities and includes exercise and facilitated 'yarning' discussion about fall risk and prevention strategies. The programme pilot showed favourable outcomes and acceptability for Aboriginal people aged 45 years and over. The programme is now being compared with a '' programme in a cluster randomised controlled trial within Aboriginal health and community services. An embedded process evaluation aims to explore relationships between participation and programme outcomes and the quality of programme implementation.

METHODS AND ANALYSIS

The process evaluation will use a mixed methods design, guided by Indigenous research methodology. It will evaluate quantitative data (number of completed sessions, site coaching checklist tool, participant and facilitator questionnaire data and a participant habit formation scale), as well as qualitative data (open-ended responses from project and site staff and semistructured interviews using yarning with study participants and site managers). A programme logic model was developed to explain the intended inputs, activities, outputs and outcomes, which guided this process evaluation design.

CONCLUSION

This process evaluation of a fall prevention programme for older Aboriginal people using a mixed methods design and data triangulation will allow for a comprehensive understanding of study findings. Multiple study sites allow for generalisability of findings and exploration of variation across sites.

TRIAL REGISTRATION NUMBER

ACTRN12619000349145.

摘要

引言

审查项目实施情况的过程评估通常与有效性研究同时进行。将其纳入针对原住民参与者的研究中,有助于了解原住民社区背景下的项目实施情况。该项目是与原住民社区共同设计的,包括锻炼以及就跌倒风险和预防策略展开的引导式“交流”讨论。该项目试点对45岁及以上的原住民显示出了良好的效果和可接受性。目前,该项目正在原住民健康和社区服务领域的一项整群随机对照试验中与一个“对照”项目进行比较。一项嵌入式过程评估旨在探索参与度与项目成果之间的关系以及项目实施的质量。

方法与分析

过程评估将采用混合方法设计,并以原住民研究方法为指导。它将评估定量数据(完成的课程数量、现场指导清单工具、参与者和指导者问卷数据以及参与者习惯形成量表)以及定性数据(项目和现场工作人员的开放式回答,以及与研究参与者和现场管理人员进行交流的半结构化访谈)。开发了一个项目逻辑模型来解释预期的投入、活动、产出和成果,该模型指导了这一过程评估设计。

结论

这项针对老年原住民预防跌倒项目的过程评估采用混合方法设计和数据三角测量法,将有助于全面理解研究结果。多个研究地点使研究结果具有可推广性,并能探索不同地点之间的差异。

试验注册号

ACTRN12619000349145。

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