Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne, Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Eupener Str. 129, 50933, Cologne, Germany.
BMC Health Serv Res. 2022 Apr 22;22(1):531. doi: 10.1186/s12913-022-07951-1.
Evaluating the development phase of a complex intervention programme can be challenging. A prospective evaluation approach is presented based on the example of the new complex psycho-oncological care programme isPO (integrated, cross-sectoral Psycho-Oncology). Prior to programme implementation, we examined (1) if isPO was developed as intended, and (2) if it was relevant and transferable into the newly developed psycho-oncological care networks in North-Rhine Westphalia, Germany. Further, we investigated which implementation facilitators and barriers were anticipated and which implementation strategies were planned by the programme designers (multidisciplinary professionals and cancer supporting organizations who developed the isPO programme components and the networks).
A mixed-methods approach was applied. Qualitative data were collected by quarterly progress reports, interviews and a focus group with the programme designers. Evaluation criteria for document analyses of the quarterly progress reports were developed and applied. Content analysis was applied for analysing interviews and focus group. Quantitative data were gained from evaluating the programme training for the isPO service providers by short written questionnaires that were analysed descriptively.
An implementable prototype of the isPO programme has been developed within 15 months, however no piloting was conducted. The programme's complexity proved to be challenging with regard to coordination and communication of the numerous programme designers. This was intensified by existing interdependencies between the designers. Further, there was little communication and participation between the programme designers and the prospective users (patients and service providers). Due to these challenges, only context-unspecific implementation strategies were planned.
The required resources for developing a new complex care programme and the need of a mature implementation strategy should be sufficiently addressed. Programmes may benefit from prospective evaluation by gaining insightful knowledge concerning the programme's maturity and anticipating implementation facilitators and barriers. A mixed-methods evaluation design was crucial for achieving profound insight into the development process.
The study has been registered in the German Clinical Trials Register (No. DRKS00015326 ) on 30.10.2018.
评估复杂干预项目的开发阶段可能具有挑战性。本文提出了一种基于新的复杂心理肿瘤学护理项目 isPO（综合跨部门心理肿瘤学）的前瞻性评估方法。在项目实施之前，我们检查了（1）isPO 是否按照预期进行开发，以及（2）它是否与德国北莱茵-威斯特法伦州新开发的心理肿瘤学护理网络相关且可转移。此外，我们还调查了项目设计者预计的哪些实施促进因素和障碍，以及计划采用哪些实施策略（开发了 isPO 项目组件和网络的多学科专业人员和癌症支持组织）。
采用混合方法。通过季度进展报告、访谈和与项目设计者的焦点小组收集定性数据。制定并应用了季度进展报告的文件分析评价标准。采用内容分析法分析访谈和焦点小组。通过对 isPO 服务提供者进行方案培训的简短书面问卷评估获得定量数据，并进行描述性分析。
在 15 个月内开发了可实施的 isPO 方案原型，但未进行试点。由于众多方案设计者之间的协调和沟通，该方案的复杂性具有挑战性。设计师之间现有的相互依存关系加剧了这一挑战。此外，方案设计者与预期使用者（患者和服务提供者）之间几乎没有沟通和参与。由于这些挑战，仅计划了非特定于情境的实施策略。
开发新的复杂护理方案所需的资源和成熟的实施策略的需求应得到充分解决。通过获得有关方案成熟度的深入了解并预测实施促进因素和障碍，方案可能会受益于前瞻性评估。混合方法评估设计对于深入了解开发过程至关重要。
该研究于 2018 年 10 月 30 日在德国临床试验注册处（DRKS00015326）注册。
