Building readiness in community-based organisations to enable the implementation of public health interventions for adults and older adults: a scoping review

提升社区组织开展针对成人和老年人的公共卫生干预措施的能力:一项范围界定综述

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Abstract

BACKGROUND: A key challenge to implementing and scaling up evidence-based interventions (EBIs) into practice is organisational readiness; described as an organisation's motivation, general capacities, and capabilities specific to the EBI. Building organisational readiness has been investigated in some health disciplines (e.g., mental health). However, the importance of building organisational readiness to effectively implement public health EBIs for adults and older adults in the community setting remains largely unexplored. Our aim was to examine how readiness was defined and measured, what strategies were used to build readiness, and the relationship between readiness-building strategies and implementation, service-level, and person-level outcomes. METHODS: In this scoping review, we searched seven databases and conducted forward and backward citation tracking. From a pool of eight reviewers, combinations of two reviewers independently screened references for eligibility. A single reviewer extracted data, and a second reviewer checked data. Results for each implementation, service-level and person-level outcome in each study were extracted and categorised as favourable, nonsignificant, or unfavourable. RESULTS: Twelve studies were included, which implemented a mix of different public health EBIs to almost 40,000 participants (n = 37,883; 54% women) across varied community settings. Only four studies defined readiness; all used different definitions. Five studies used five different instruments to assess readiness, all with poor psychometric properties. All studies used multiple strategies to build readiness (range 4-20 strategies per study), with all using strategies to assess, plan and monitor implementation of the EBI (i.e., 'evaluative and iterative strategies') and strategies to support collaboration between organisations delivering the EBI (i.e., 'develop interest-holder interrelationships'). Three-quarters of the strategies focused on building the organisation's capability to deliver the specific EBI (e.g., assessing readiness, conducting educational meetings) and were delivered by external support teams. Exploring the relationship between readiness-building strategies and study outcomes indicated more favourable than unfavourable outcomes, particularly for implementation and service-level outcomes (38/48; 79% favourable). CONCLUSIONS: Within this limited sample, the use of readiness-building strategies improved the implementation of public health EBIs in community organisations. However, consistency of definitions and terminology and more sophisticated testing of readiness-building strategies will help confirm how best to do this. TRIAL REGISTRATION: Open Science Framework, May 5, 2024.

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