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一项旨在建立实施能力的促进培训干预措施的纵向混合方法评估。

A longitudinal mixed methods evaluation of a facilitation training intervention to build implementation capacity.

作者信息

Costea Veronica-Aurelia, Bäck Annika, Bergström Anna, Lundin Andreas, Hasson Henna, Eriksson Leif

机构信息

PROCOME Research Group, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Stockholm, Sweden.

出版信息

Front Health Serv. 2024 Sep 13;4:1408801. doi: 10.3389/frhs.2024.1408801. eCollection 2024.

Abstract

BACKGROUND

There is a demand for facilitators who can ease the collaboration within a team or an organization in the implementation of evidence-based interventions (EBIs) and who are positioned to build the implementation capacity in an organization. This study aimed to evaluate the results the Building implementation capacity for facilitation (BIC-F) intervention had on the participants' perceived knowledge, skills, and self-efficacy to facilitate implementation and the normalization of a systematic implementation model into their work routines, and its use into their respective organizations.

METHODS

The BIC-F intervention was delivered to 37 facilitators in six workshops, which focused on teaching participants to apply a systematic implementation model and various facilitation tools and strategies. A longitudinal mixed methods design was used to evaluate the intervention. Data was collected pre- and post-intervention using questionnaires and semi-structured interviews grounded on the Normalization Process Theory (NPT). Quantitative data were analyzed using descriptive (mean, SD) and inferential (paired t-tests) methods. Qualitative data were analyzed using deductive content analysis according to NPT.

RESULTS

An increase in the participants' perceived knowledge, skills, and self-efficacy was observed post-intervention. Normalization of the systematic implementation model in the participants' work routines was in an early phase, facilitated by high coherence, however, other NPT mechanisms were not sufficiently activated yet to contribute to full normalization. In the organizations where participants initiated the normalization process, they were still working towards achieving coherence and cognitive participation among relevant stakeholders.

CONCLUSION

The intervention had positive results on the participants' perceived knowledge, skills, and self-efficacy and these recognized the value of a systematic implementation model for their practice. However, further efforts are needed to apply it consistently as a part of their work routines and in the organization. Future interventions should provide long-term support for facilitators, and include methods to transfer training between organizational levels and to overcome contextual barriers.

摘要

背景

在循证干预措施(EBI)的实施过程中,需要推动者来促进团队或组织内部的协作,并提升组织的实施能力。本研究旨在评估促进实施能力建设(BIC-F)干预措施对参与者在促进实施方面的感知知识、技能和自我效能的影响,以及将系统实施模型融入其工作流程并在各自组织中应用的情况。

方法

在六个工作坊中,向37名推动者提供了BIC-F干预措施,这些工作坊专注于教导参与者应用系统实施模型以及各种促进工具和策略。采用纵向混合方法设计来评估该干预措施。干预前后通过问卷调查和基于规范化过程理论(NPT)的半结构化访谈收集数据。定量数据采用描述性(均值、标准差)和推断性(配对t检验)方法进行分析。定性数据根据NPT采用演绎内容分析法进行分析。

结果

干预后观察到参与者的感知知识、技能和自我效能有所提高。系统实施模型在参与者工作流程中的规范化尚处于早期阶段,高一致性起到了促进作用,然而,其他NPT机制尚未充分激活以促成完全规范化。在参与者启动规范化过程的组织中,他们仍在努力实现相关利益攸关方之间的一致性和认知参与。

结论

该干预措施对参与者的感知知识、技能和自我效能产生了积极影响,并且他们认识到系统实施模型对其实践的价值。然而,需要进一步努力将其作为工作流程的一部分并在组织中持续应用。未来的干预措施应为推动者提供长期支持,并包括在组织层面之间转移培训以及克服背景障碍的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fe5/11427355/6f61d15b52c7/frhs-04-1408801-g001.jpg

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