Fidelity Evaluation of the Compared Procedures for Conducting the PVS-PREDIAPS Implementation Strategy to Optimize Diabetes Prevention in Primary Care

Overview

Journal BMC Fam Pract

Publisher Biomed Central

Specialties Health Services
Public Health

Date 2021 Feb 12

PMID 33573600

Citations 3

Authors

Alvaro Sanchez

Heather L Rogers

Susana Pablo

Esther Garcia

Inmaculada Rodriguez

MA Antonia Flores

Olga Galarza

Ana B Gaztanaga

Pedro A Martinez

Eider Alberdi

Elena Resines

Ana I Llarena

Gonzalo Grandes

Affiliations

Soon will be listed here.

Abstract

Background: Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in routine PC within the PREDIAPS randomized cluster implementation trial.

Method: We conducted a mixed-method fidelity evaluation study of the PVS-PREDIAPS implementation strategy. Nine PC centers from the Basque Health Service (Osakidetza) were allocated to two different procedures to engage physicians and nurses and deploy a implementation strategy to model and adapt the clinical intervention and its implementation to their specific contexts: a Global procedure, promoting the cooperation of all healthcare professionals from the beginning; or a Sequential procedure, centered first on nurses who then pursued the pragmatic cooperation of physicians. Process indicators of the delivery and receipt of implementation strategy actions, documented modifications to the planned implementation strategy, and a structured group interview with centers' leaders were all used to assess the following components of fidelity: adherence, dose, quality of delivery, professionals' responsiveness and program differentiation.

Results: Generally, the procedures compared for professionals engagement and deployment of the implementation strategy were carried out with the planned differentiation. Nonetheless, some unexpected between-group differences were observed, the initial rate of collaboration of nurses being higher in the Sequential (93%) than in the Global (67%) groups. Exposure rate to the programed implementation actions (% of hours received out of those delivered) were similar in both groups by professional category, with nurses (86%) having a higher rate of exposure than physicians (75%). Professionals identified half of the planned discrete strategies and their rating of strategies' perceived usefulness was overwhelmingly positive, with few differences between Sequential and Global centers.

Conclusions: The PVS-PREDIAPS implementation strategy has been implemented with high fidelity and minor unplanned reactive modifications. Professionals' exposure to the implementation strategy was high in both groups. The centers' organizational context (i.e., work overload) led to small mismatches between groups in participation and exposure of professionals to implementation actions.

Trial Registration: Clinicaltrials.gov identifier: NCT03254979 . Registered 16 August 2017.

Citing Articles

[From evidence to practice: The Disemination and Implementation Science in primary care].

Martinez C, Camarelles Guillem F, Gonzalez-Viana A, Sanchez A, Tigova O, Fernandez E Aten Primaria. 2024; 57(1):103077.

PMID: 39265319 PMC: 11415847. DOI: 10.1016/j.aprim.2024.103077.

De-imFAR phase II project: a study protocol for a cluster randomised implementation trial to evaluate the effectiveness of de-implementation strategies to reduce low-value statin prescribing in the primary prevention of cardiovascular disease.

Sanchez A, Pijoan J, Sainz de Rozas R, Lekue I, San Vicente R, Quindimil J BMJ Open. 2024; 14(4):e078692.

PMID: 38631840 PMC: 11029292. DOI: 10.1136/bmjopen-2023-078692.

Effectiveness of two procedures for deploying a facilitated collaborative modeling implementation strategy-the PVS-PREDIAPS strategy-to optimize type 2 diabetes prevention in primary care: the PREDIAPS cluster randomized hybrid type II....

Sanchez A, Pablo S, Garcia-Alvarez A, Dominguez S, Grandes G Implement Sci. 2021; 16(1):58.

PMID: 34044869 PMC: 8161614. DOI: 10.1186/s13012-021-01127-x.

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