Bridging the knowledge-practice gap in tuberculosis contact management in a high-burden setting: a mixed-methods protocol for a multicenter health system ... View Full Text


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Article Info

DATE

2019-12

AUTHORS

Trisasi Lestari, Steve Graham, Christel van den Boogard, Rina Triasih, Jeanne Rini Poespoprodjo, Reynold Rizal Ubra, Enny Kenangalem, Yodi Mahendradhata, Nicholas M. Anstey, Ross S. Bailie, Anna P. Ralph

ABSTRACT

BACKGROUND: People in close contact with tuberculosis should have screening and appropriate management, as an opportunity for active case detection and prevention. However, implementation of tuberculosis contact screening and management is limited in high-burden settings. Behaviour change is needed across three levels of the healthcare system-policymakers, healthcare providers, and patients. To bridge the wide policy-practice gap, this study draws on the Consolidated Framework for Implementation Research, the Behaviour Change Wheel, and the RE-AIM model (Reach, Effectiveness, Adoption, Implementation, Maintenance) to respectively understand barriers, implement change, and evaluate process and outcome. METHODS: This methods paper describes a mixed-methods intervention study in Eastern Indonesia. Quantitative data will be collected during baseline, intervention, and sustainability periods and analyzed using time series analysis. The primary outcome is the number of individuals completing tuberculosis preventive therapy by the end of the two-year intervention phase. Of an estimated 10,000 contacts during this period, we anticipate that a minimum of 416 will be found to have active TB or will complete preventive therapy. Qualitative data (semi-structured interviews, focus group discussions, and observations) will be collected from consenting healthcare providers, patients, and contacts. Activities to promote policy implementation include healthcare provider training, quarterly continuous quality improvement workshops, a social media discussion forum, and promotional materials. The Consolidated Framework for Implementation Research will be used to identify reasons for limited policy implementation at baseline. The Behaviour Change Wheel will be used to ensure that a suitable range of activities are implemented to facilitate change. The RE-AIM model will be used as the evaluation framework. DISCUSSION: Use of theoretical frameworks in combination can ensure a comprehensive understanding of, and robust response to, health policy underimplementation. The selected frameworks are highly applicable to this pragmatic intervention study, in a setting where End TB Strategy targets will not be met without substantial behavior change within health systems. Continuous quality improvement cycles will provide a way to engage staff and stakeholders in understanding local data to motivate behavior change. If successful, up to 500 people could be prevented from developing complications of tuberculosis through early case-finding or receiving preventive therapy over a two-year period. STUDY REGISTRATION: Australian New Zealand Clinical Trials Register 375803 . More... »

PAGES

31

References to SciGraph publications

  • 2011-12. The behaviour change wheel: A new method for characterising and designing behaviour change interventions in IMPLEMENTATION SCIENCE
  • 2009-12. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science in IMPLEMENTATION SCIENCE
  • 2014-12. Duration of participation in continuous quality improvement: a key factor explaining improved delivery of Type 2 diabetes services in BMC HEALTH SERVICES RESEARCH
  • 2013-12. Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach in BMC HEALTH SERVICES RESEARCH
  • 2015-09. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research in ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH
  • 2015-12. A systematic review of the use of the Consolidated Framework for Implementation Research in IMPLEMENTATION SCIENCE
  • 2010-12. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations in IMPLEMENTATION SCIENCE
  • 2017-12. Identifying barriers to and facilitators of tuberculosis contact investigation in Kampala, Uganda: a behavioral approach in IMPLEMENTATION SCIENCE
  • 2015-12. Barriers to adherence with tuberculosis contact investigation in six provinces of Vietnam: a nested case–control study in BMC INFECTIOUS DISEASES
  • 2010-12. The burden and treatment of HIV in tuberculosis patients in Papua Province, Indonesia: a prospective observational study in BMC INFECTIOUS DISEASES
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    http://scigraph.springernature.com/pub.10.1186/s13012-019-0870-x

    DOI

    http://dx.doi.org/10.1186/s13012-019-0870-x

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30890160


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    N-Triples is a line-based linked data format ideal for batch operations.

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    RDF/XML is a standard XML format for linked data.

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