Adapting health interventions for local fit when scaling-up: A realist review protocol

Title: Adapting health interventions for local fit when scaling-up: A realist review protocol
Authors: Power, Jessica
Gilmore, Brynne
Vallières, Frédérique
Toomey, Elaine
Mannan, Hasheem
McAuliffe, Eilish
Permanent link: http://hdl.handle.net/10197/10790
Date: 24-Jan-2019
Online since: 2019-06-11T09:27:22Z
Abstract: Introduction: Scaling-up is essential to ensure universal access of effective health interventions. Scaling-up is a complex process, which occurs across diverse systems and contexts with no one-size-fits-all approach. To date, little attention has been paid to the process of scaling-up in how to make adaptations for local fit. The aim of this research is to develop theory on what actions can be used to make adaptations to health interventions for local fit when scaling-up across diverse contexts that will have practical application for implementers involved in scaling-up. Methods and analysis: Given the complexity of this subject, a realist review methodology was selected. Specifically, realist review emphasises an iterative, non-linear process, whereby the review is refined as it progresses. The identification of how the context may activate mechanisms to achieve outcomes is used to generate theories on what works for whom in what circumstances. This protocol will describe the first completed stage of development of an initial programme theory framework, which identified potential actions, contexts, mechanisms and outcomes that could be used to make adaptations when scaling-up. It will then outline the methods for future stages of the review which will focus on identifying case examples of scale-up and adaptation in practice. This realist review consists of six stages: (i) clarifying scope and development of a theoretical framework, (ii) developing a search strategy, (iii) selection and appraisal, (iv) data extraction, (v) data synthesis and analysis and (vi) further theory refinement with stakeholders. Ethics and dissemination: This review will develop theory on how adaptations can be made when scaling-up. Findings will be disseminated in a peer-reviewed journal and through stakeholder engagement as part of the research process. Ethical approval has been received through Health Policy and Management/Centre for Global Health Research Ethics Committee of Trinity College Dublin.
Funding Details: Health Research Board
Type of material: Journal Article
Publisher: BMJ
Journal: BMJ Open
Volume: 9
Issue: 1
Start page: e022084
Copyright (published version): 2019 the Authors
Keywords: Health interventionsScaling-upRealist reviewRealist synthesisInitial programme theory (IPT) framework
DOI: 10.1136/bmjopen-2018-022084
Language: en
Status of Item: Peer reviewed
Appears in Collections:Nursing, Midwifery & Health Systems Research Collection

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