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Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness

Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness
Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness
Background
The implementation of complex interventions experiences challenges that affect the extent to which they become embedded and scaled-up. Implementation at scale in complex environments like community settings defies universal replication. Planning for implementation in such environments requires knowledge of organisational capacity and structure. Pre-implementation work is an important element of the early phase of preparing the setting for the introduction of an intervention, and the factors contributing towards the creation of an optimal pre-implementation community context are under-acknowledged.

Methods
To explore the factors contributing towards the creation of an optimal pre-implementation context, a quasi-ethnographic approach was taken. The implementation of a social network intervention designed to tackle loneliness in a community setting acts as the case in example. Observations (of meetings), interviews (with community partners) and documentary analysis (national and local policy documents and intervention resources) were conducted. Layder’s adaptive theory approach was taken to data analysis, with the Consolidated Framework for Implementation Research (CFIR) and a typology of third-sector organisations used to interpret the findings.

Results
Community settings were found to sit along a continuum with three broad categories defined as Fully Professionalised Organisations; Aspirational Community, Voluntary and Social Enterprises; and Non-Professionalised Community-Based Groups. The nature of an optimal pre-implementation context varied across these settings. Using the CFIR, the results illustrate that some settings were more influenced by political landscape (Fully professional and Aspirational setting) and others more influenced by their founding values and ethos (Non-Professionalised Community-Based settings). Readiness was achieved at different speeds across the categories with those settings with more resource availability more able to achieve readiness (Fully Professional settings), and others requiring flexibility in the intervention to help overcome limited resource availability (Aspirational and Non-Professionalised Community-Based settings).

Conclusions
The CFIR is useful in highlighting the multiple facets at play in creating the optimal pre-implementation context, and where flex is required to achieve this. The CFIR illuminates the similarities and differences between and across settings, highlighting the complexity of open system settings and the important need for pre-implementation work.
1748-5908
Ellis, Jaimie
eb60a3a4-281b-4895-9583-4d5cf1e65b4d
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Kinsella, Karina
db8e7562-4b53-4007-9753-f9382b09cdb0
Cheetham-Blake, Tara
99ea7608-7d19-4e78-bd98-5ca3ca1c46f1
James, Elizabeth
b7e90b5a-da45-4459-ae84-150adc07e988
Ewings, Sean
326656df-c0f0-44a1-b64f-8fe9578ca18a
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Ellis, Jaimie
eb60a3a4-281b-4895-9583-4d5cf1e65b4d
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Kinsella, Karina
db8e7562-4b53-4007-9753-f9382b09cdb0
Cheetham-Blake, Tara
99ea7608-7d19-4e78-bd98-5ca3ca1c46f1
James, Elizabeth
b7e90b5a-da45-4459-ae84-150adc07e988
Ewings, Sean
326656df-c0f0-44a1-b64f-8fe9578ca18a
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7

Ellis, Jaimie, Band, Rebecca, Kinsella, Karina, Cheetham-Blake, Tara, James, Elizabeth, Ewings, Sean and Rogers, Anne (2020) Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness. Implementation Science, 15 (1), [35]. (doi:10.1186/s13012-020-00997-x).

Record type: Article

Abstract

Background
The implementation of complex interventions experiences challenges that affect the extent to which they become embedded and scaled-up. Implementation at scale in complex environments like community settings defies universal replication. Planning for implementation in such environments requires knowledge of organisational capacity and structure. Pre-implementation work is an important element of the early phase of preparing the setting for the introduction of an intervention, and the factors contributing towards the creation of an optimal pre-implementation community context are under-acknowledged.

Methods
To explore the factors contributing towards the creation of an optimal pre-implementation context, a quasi-ethnographic approach was taken. The implementation of a social network intervention designed to tackle loneliness in a community setting acts as the case in example. Observations (of meetings), interviews (with community partners) and documentary analysis (national and local policy documents and intervention resources) were conducted. Layder’s adaptive theory approach was taken to data analysis, with the Consolidated Framework for Implementation Research (CFIR) and a typology of third-sector organisations used to interpret the findings.

Results
Community settings were found to sit along a continuum with three broad categories defined as Fully Professionalised Organisations; Aspirational Community, Voluntary and Social Enterprises; and Non-Professionalised Community-Based Groups. The nature of an optimal pre-implementation context varied across these settings. Using the CFIR, the results illustrate that some settings were more influenced by political landscape (Fully professional and Aspirational setting) and others more influenced by their founding values and ethos (Non-Professionalised Community-Based settings). Readiness was achieved at different speeds across the categories with those settings with more resource availability more able to achieve readiness (Fully Professional settings), and others requiring flexibility in the intervention to help overcome limited resource availability (Aspirational and Non-Professionalised Community-Based settings).

Conclusions
The CFIR is useful in highlighting the multiple facets at play in creating the optimal pre-implementation context, and where flex is required to achieve this. The CFIR illuminates the similarities and differences between and across settings, highlighting the complexity of open system settings and the important need for pre-implementation work.

Text
Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness - Accepted Manuscript
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More information

Accepted/In Press date: 3 May 2020
e-pub ahead of print date: 19 May 2020

Identifiers

Local EPrints ID: 441075
URI: http://eprints.soton.ac.uk/id/eprint/441075
ISSN: 1748-5908
PURE UUID: 6e6cfd54-c64e-4d48-bfc2-d955611b7ac2
ORCID for Jaimie Ellis: ORCID iD orcid.org/0000-0003-0068-3318
ORCID for Rebecca Band: ORCID iD orcid.org/0000-0001-5403-1708
ORCID for Elizabeth James: ORCID iD orcid.org/0000-0001-9355-0295
ORCID for Sean Ewings: ORCID iD orcid.org/0000-0001-7214-4917

Catalogue record

Date deposited: 29 May 2020 16:30
Last modified: 24 Jun 2022 01:41

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Contributors

Author: Jaimie Ellis ORCID iD
Author: Rebecca Band ORCID iD
Author: Karina Kinsella
Author: Tara Cheetham-Blake
Author: Elizabeth James ORCID iD
Author: Sean Ewings ORCID iD
Author: Anne Rogers

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