Monitoring and evaluating an implementation strategy aimed at improving interprofessional collaboration in community-based fall prevention: a mixed-methods study

监测和评估旨在改善社区防跌倒中跨专业协作的实施策略:一项混合方法研究

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Abstract

BACKGROUND: Interprofessional collaboration (IPC) among health and social care providers is crucial to effectively implement community-based fall prevention. Several factors hinder successful and sustainable IPC, highlighting the need to both design and evaluate context-specific implementation strategies. However, there remains a fundamental gap in the detailed description and evaluation of such strategies. Therefore, this study aims to (1) monitor the implementation process over time and (2) evaluate the impact of a multifaceted implementation strategy aimed at improving interprofessional collaboration among health and social care professionals in community-based fall prevention. METHODS: This study was conducted in two districts and one municipality in the Netherlands. We conducted a longitudinal mixed-methods study with a convergent design, emphasizing qualitative methodology. Over 24 months, qualitative (focus groups and regular meetings) and quantitative (questionnaires) data were collected semi-annually from three working groups of health and social care professionals (HSCPs). Qualitative and quantitative data were initially analyzed separately, followed by an integrated analysis for comprehensive insights on themes influencing the implementation process and the impact of the strategy on IPC and implementation outcomes. RESULTS: In total, 32 HSCPs originating from three communities participated in this study. Monitoring and evaluation of the multifaceted implementation strategy revealed four overarching themes: (1) "Network building", including aspects and activities that contribute to network building; (2) "Team dynamics", referring to interactions within the working groups; (3) "Coordination", addressing the coordination of implementation and establishment of protocols and work flows; and (4) "Implementation dynamics" highlighting aspects that influence the implementation process and outcomes. CONCLUSIONS: This study identified four key themes influencing the implementation process and impact of a multifaceted implementation strategy aimed at improving IPC among HSCPs in community-based fall prevention: network building, team dynamics, coordination and implementation dynamics. Monitoring and evaluation are crucial for identifying the specific activities needed to effectively implement interventions in real-world settings. Given the complexity of implementation processes and ongoing contextual changes, continuous adjustments are necessary. An iterative monitoring and evaluation approach, as used in this study, enables these adaptations and maximizes real-world impact.

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