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Developing a tool for supporting health-system guidance implementation paper 2: a developmental and formative
Qi Wang1, Michael G Wilson2, Holger J Schünemann3
1McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Li Ka Shing Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China.
Objectives:
To develop a practical tool to support the implementation of health-system guidance (HSG).
Study Design And Setting:
The study followed a three-phase process: (1) organizing the components derived from a preceding Delphi study into a structured layout and refining it through team discussions using selected HSG examples; (2) conducting a formative evaluation to assess the tool's face validity and perceived usability through semistructured qualitative interviews and a think-aloud approach; and (3) finalizing the tool's structure and layout based on the findings from the formative evaluation.
Results:
The HSG implementation tool, consisting of a quick reference guide and a checklist, underwent formative evaluation as part of its development process. A total of 17 interviews were conducted from 11 countries, resulting in the identification of nine key themes. Four of these themes were related to the tool's face validity: appropriate overall structure, comprehensive and relevant items, helpful illustrative considerations, and interactive comment section. Most participants expressed a willingness to use the tool, provided insights into potential application scenarios, and suggested areas for further refinement.
Conclusions:
This study developed a practical tool to support HSG implementation, offering a structured approach to help policymakers and other relevant actors systematically consider essential factors and strategies when planning HSG implementation.
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