Do process evaluations open up the ‘black box’ of implementation interventions in health care? A scoping review
Notice bibliographique
Résumé
BACKGROUND: Process evaluations are considered an essential component in conducting and reporting complex interventions, such as those studied in randomised controlled trials (RCTs) of implementation interventions, to explain the effect of implementation interventions. Given the growth of RCTs of implementation interventions with embedded process evaluations, it is timely to review the explanatory learnings to date. This scoping review explores process evaluations of RCTs of implementation interventions to examine how studies are conducted and what insights can be offered about how and why implementation interventions achieve (or not) their intended impacts. METHODS: The scoping review was conducted in accordance with the JBI methodology. MEDLINE, CINAHL, Scopus, Web of Science and PsycINFO were searched. Articles were screened and data were extracted by two independent reviewers. RESULTS: Of the 5857 studies screened, 81 process evaluations were included. Two process evaluations reported on the same trial, resulting in a final number of n = 80 independent studies. Half of studies (48%) reported on implementation trials with no demonstrated effect on the primary outcome (null), while n = 32 (40%) reported on trials where the intervention group demonstrated positive changes in the primary outcome (positive). Seven studies (9%) had mixed findings and n = 3 (4%) studies had no reported trial outcomes. When comparing process evaluation findings from positive and null trials, few discernible patterns that clearly explained the difference in outcomes were identified. Education and training was the most common strategy used in implementation interventions, yet one of the most common implementation barriers reported related to knowledge and self-efficacy, which could indicate a misalignment. Availability of resources was the most prominent barrier for both positive and null trials and there was little evidence that implementation interventions were tailored to context despite prominent barriers and enablers at the inner and outer setting level. CONCLUSIONS: Process evaluation studies embedded in RCTs of implementation interventions are recommended as an important method to explain whether and how interventions produce their intended effect. This review suggests a need to further optimise the design and evaluation of implementation interventions, including the conduct and reporting of process evaluations, to continue advancing the science and practice of implementation. TRIAL REGISTRATION: Protocol published in Open Science Framework, May 10 2022 (Collyer et al., Process evaluations in randomised trials of implementation interventions in health care: a scoping review protocol. In Open science framework, 2022).
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,356 | 0,663 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,004 |
| Méta-épidémiologie (sens large) | 0,011 | 0,011 |
| Bibliométrie | 0,033 | 0,038 |
| Études des sciences et des technologies | 0,004 | 0,010 |
| Communication savante | 0,022 | 0,032 |
| Science ouverte | 0,006 | 0,009 |
| Intégrité de la recherche | 0,010 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; l’étiquette directe de Gemma et le classifieur distillé Codex s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».