Archives

  • 2018-07
  • 2018-10
  • 2018-11
  • 2019-04
  • 2019-05
  • 2019-06
  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-07
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • 2024-04
  • 2024-05

    • Given the aim of forming groups to

    2018-11-05

    Given the aim of forming groups to comprise a specific ratio of order Ketorolac tromethamine salt with/without challenges to optimise group functioning and dynamics, the difficulties in consistently achieving the specified composition were theorised to be important for intervention contribution and implementation fidelity. However, although groups did not always achieve the target, most programmes comprised a mix of families with and without challenges in which the latter formed the majority. Only 5 groups comprised more than 60% families with challenges. The generally high levels of adherence and engagement achieved suggest that deviations in group size/composition from the intended formations may not have been significant enough to impact negatively on group dynamics or the delivery of intervention activities. Our study – the first to our knowledge to use ENPT as the analytical framework for an empirical study of a social intervention, has several strengths. It builds on previous process evaluations of SFP 10–14 (Byrne et al., 2010; Spoth et al., 2007; Spoth, Guyll, Trudeau & Goldberg-Lillehoj, 2002) – and other trials of parenting/family interventions, which have focused primarily on assessment of pre-specified structural aspects of implementation (), by theorising implementation processes in order to provide greater understanding of how and why the programme was delivered as it was. This was done by integrating quantitative assessment of implementation (e.g. adherence, recruitment) and qualitative investigation of practitioners’ agency and the dynamics of local delivery systems, using ENPT as a theoretical framework. The qualitative dataset is important because it aids interpretation of implementation and programme behavioural outcomes (Moore et al., 2014), and offers insights into the kinds of conditions needed for the intervention to be delivered as intended when transferred to new settings. ENPT provided an effective framework to examine how intervention implementation and its variation may be shaped by interactions with local delivery systems and practitioner agency. Through using it we have addressed calls to pay greater attention to the theorisation of implementation processes and the role of intervention-context interactions in shaping their variation (Bisset et al., 2009; Bonell et al., 2012; Glasgow et al., 2006; Hawe et al., 2004), which can help optimise the explanatory value of process evaluations. Although other implementation frameworks assess moderators of fidelity (e.g. Carroll et al., 2007) and examine intervention adoption and maintenance (e.g. Glasgow et al., 1999), ENPT\'s distinctive contribution is that it offers a theory to help understand implementation processes, and how and why interventions are adopted and maintained (or not) over time. However, ENPT\'s focus is on how new forms of practice are embedded and integrated – it is not primarily a framework for assessing and explaining implementation fidelity – the main aim of process evaluations such as ours. We therefore used Linnan and Steckler\'s (2002) framework to identify those aspects of implementation that needed to be assessed, with ENPT employed to theorise implementation processes (identified in qualitative data) and the extent to which programme inputs and activities were delivered as intended (measured by quantitative data). ENPT places considerable emphasis on the notion of implementation as an expression of agency. However, the agents in question appear to be mainly conceptualised as professional practitioners (e.g. nurses), rather than the participants who receive interventions. There is scope to consider further how the key constructs of ENPT can be applied to understand how participant (and non-participant) agency may shape whether interventions become integrated and embedded within delivery systems. For example, participants’ potential towards an intervention may influence levels of recruitment and the feasibility of long-term implementation. To achieve their hypothesized mechanisms, interventions such as SFP 10–14 require certain forms of contribution from participants, including participation in group activities, and the practising of skills within the home setting, which require cooperation and coordination between and across families (capacity).