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Protocol for the implementation evaluation of an integrated paediatric and primary care model: Strengthening Care for
Michael Hodgins1, Yvonne Zurynski2, Jade Burley3
1Population Child Health Research Group, University of New South Wales, Sydney, NSW, Australia.
Insights
This study details the protocol for an implementation evaluation of the Strengthening Care for Children (SC4C) model, integrating pediatric care into general practices. It uses mixed methods to assess intervention delivery and outcomes for sustainable adoption.
Area of Science:
- Health Services Research
- Implementation Science
- Pediatric Healthcare Delivery
Background:
- Implementation evaluations are crucial for understanding intervention delivery across diverse contexts.
- The Strengthening Care for Children (SC4C) model integrates pediatric care into general practice settings.
- Understanding implementation processes is key to explaining intervention success or failure in different environments.
Purpose of the Study:
- To outline a detailed protocol for an implementation evaluation.
- To describe pragmatic methods for capturing process and outcome data within a stepped-wedge cluster randomized controlled trial.
- To inform the effective and sustainable integration of pediatric care in general practice.
Main Methods:
- A mixed-methods design incorporating questionnaires and semi-structured interviews.
- Data collection from general practitioners, pediatricians, administrative staff, children, and families.
- Utilizing the Consolidated Framework for Implementation Research (CFIR) and Proctor's taxonomy for data analysis and outcome measurement.
Main Results:
- The evaluation will capture data on intervention use, acceptability, and effectiveness within 21 general practices.
- Quantitative data will be analyzed using the CFIR validated scoring system.
- Qualitative data analysis will employ an inductive approach to identify emerging themes and contextual factors.
Conclusions:
- The protocol provides a robust framework for evaluating the implementation of integrated care models.
- Findings will offer insights into factors influencing the sustainable adoption of the SC4C intervention.
- This evaluation will contribute to optimizing pediatric care delivery within primary care settings.
Introduction:
Implementation evaluations provide insight into how interventions are delivered across varying contexts and why interventions work in some contexts and not in others. This manuscript outlines a detailed protocol of an implementation evaluation embedded in a stepped-wedge cluster randomised controlled trial of a model of care, Strengthening Care for Children (SC4C), that integrates paediatric care in general practice. The purpose of this manuscript is to describe the pragmatic methods that will be used to capture implementation evaluation process and outcome data within this trial.
Methods And Analysis:
Our implementation evaluation will use a mixed methods design, with data collected in the intervention arm of the SC4C trial guided by a logic model developed using the Consolidated Framework for Implementation Research (CFIR) and Proctor and colleague's taxonomy of implementation outcomes. Data collection will be via questionnaires and semistructured interviews with general practitioners, paediatricians, general practice administrative staff and children and families. Each of the 21 general practices recruited into the study will be described in terms of staffing, patient throughput and location, in addition to the nuanced inner and outer contexts, use of the intervention and its acceptability. We will quantify implementation effectiveness in each general practice clinic using the CFIR validated scoring system. Importantly, we have embedded data collection post intervention to enable assessment of the sustainable adoption of the intervention. An inductive approach to the analysis of qualitative data will identify additional emerging themes that may not be covered by the formal frameworks underpinning our analysis.
Ethics And Dissemination:
Ethical approval was granted by the Royal Children's Hospital Ethics Committee in August 2020 (HREC: 65955). Results will be submitted for publication in peer-reviewed journals and presented at relevant conferences.
Trial Registration Number:
Australia New Zealand Clinical Trials Registry 12620001299998 on 1 December 2020.
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