Implementation of an integrated community approach in deprived neighbourhoods: a theory-based process evaluation using the Consolidated Framework for Implementation Research (CFIR).
| Autor: | Grootjans, Sanneke J.M., Stijnen, M.M.N., Hesdahl-De Jong, I., Kroese, M.E.A.L., Ruwaard, D., Jansen, M.W.J. |
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| Předmět: |
COMMUNITY health services
HEALTH services accessibility MEDICAL quality control RESEARCH funding EXECUTIVES FOCUS groups INTERPROFESSIONAL relations HUMAN services programs POPULATION health management POPULATION health SOCIOECONOMIC status RESEARCH evaluation INTERVIEWING LEADERSHIP EVALUATION of human services programs DESCRIPTIVE statistics HEALTH care reform JOB satisfaction SOUND recordings RESEARCH methodology CONCEPTUAL structures STAKEHOLDER analysis INTEGRATED health care delivery SOCIAL classes NEIGHBORHOOD characteristics COMMUNITY-based social services HEALTH care teams |
| Zdroj: | Scandinavian Journal of Public Health; Nov2024, Vol. 52 Issue 7, p838-848, 11p |
| Abstrakt: | Background: We investigated the implementation process of an Integrated Community Approach (ICA) applied in four low socio-economic status neighbourhoods in Maastricht, the Netherlands. The ICA is a Population Health Management initiative and aims to improve population health, quality of care, professional's satisfaction and decrease costs of care. This study addresses the facilitators and barriers for implementing the ICA from a stakeholder perspective, including steering group members, professionals and citizens. Methods: We conducted a mixed-methods study using a triangulation of methods to investigate the implementation from 1 December 2016 to 31 December 2020. The Consolidated Framework for Implementation Research guided data collection and data-analysis for evaluating the implementation process. In total, 77 interviews, 97 observations, seven focus groups, 65 collected documents and two surveys with open-ended questions were conducted. Results: Facilitators for implementation were the use of citizen science to bring residents' needs into sharp focus, the integration of the ideology of Positive Health into the working routines of the professionals and leadership at the steering group level to overcome barriers in the ICA. The existing accounting and financial infrastructure obstructed combining budgets at neighbourhood level. Conclusions: Engaging citizens and professionals at an early stage is an important facilitator for implementation. The use of a shared vision on health also worked as a facilitator since it created a shared language among professionals, which is important in Population Health Management initiatives where multiple professionals are expected to collaborate. Trial Registration: NTR 6543; registration date, 25 July 2017. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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