Implications of process evaluation for clinical effectiveness and clinical practice in a trial on chronic shoulder complaints

Geraets, Jacques; Goossens, Mariëlle E. J. B.; Haastregt, Jolanda C. M. van; Groot, I. de; Bruijn, Camiel P. C. de; Bie, Rob A. de; Köke, Albère; Heuvel, W.J.A. van den

doi:10.1016/j.pec.2005.02.017

Cited by 13 publications

(6 citation statements)

References 21 publications

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“…We did a mixed-methods process evaluation within a quasi-experimental design to assess feasibility of delivering the intervention and describe transferable principles about the intervention to inform its implementation on a wider scale [19][20][21][22]. We considered context, reach, dose delivered, dose received, and recruitment [23].…”

Section: Process Evaluation and Analysismentioning

confidence: 99%

Development and feasibility of an intervention featuring individual supported work placements to aid return to work for unemployed people living with chronic pain

Froud

Grant

Burton

et al. 2020

Pilot Feasibility Stud

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Background: Working in good jobs is associated with good health. High unemployment rates are reported in those disabled with musculoskeletal pain. Supported employment interventions work well for helping people with mental health difficulties to gain and retain employment. With adaptation, these may be useful for people with chronic pain. We aimed to develop and explore the feasibility of delivering such an adapted intervention. Methods:We developed an intervention and recruited unemployed people with chronic pain from NHS pain clinics and employment services. We trained case managers to assess participants and match them to six-week work placements in the Midlands and provide ongoing support to them and their managers. Participants attended a two-day work preparation session prior to placement. Outcome measures included quality of life at baseline, sixweeks, 14-weeks, and six-months, and return to work at 14-weeks and six-months. We held focus groups or interviews with stakeholders to examine acceptability and experiences of the intervention.(Continued on next page) Results: We developed an intervention consisting of work preparation sessions, work experience placements, and individualised employment support. We enrolled 31 people; 27 attended work preparation sessions, and 15 attended placements. Four of our participants started jobs during the study period. We are aware of two others starting jobs shortly after cessation of follow-up. We experienced challenges to recruitment in one area where we had many and diverse placement opportunities and good recruitment in another area where we had a smaller range of placement opportunities. All stakeholders found the intervention acceptable, and it was valued by those given a placement. While there was some disappointment among those not placed, this group still valued the work preparation sessions. Conclusions: The developed intervention was acceptable to participants and partners. Trialling the developed intervention could be feasible with attention to three main processes. To ensure advanced availability of a sufficiently wide range of work placements in each area, multiple partners would be needed. Multiple recruitment sites and focus on employment services will yield better recruitment rates than reliance on NHS pain clinics. Maintaining an adequate follow-up response rate will likely require additional approaches with more than the usual effort.

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Section: Process Evaluation and Analysismentioning

confidence: 99%

Development and feasibility of an intervention featuring individual supported work placements to aid return to work for unemployed people living with chronic pain

Froud

Grant

Burton

et al. 2020

Pilot Feasibility Stud

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“…A number of authors have described the use of process evaluation in complex intervention trials, pointing out the value of being able to place findings into context, understanding both how the intervention was delivered and how the social, political and physical context impacted on its effectiveness. [109][110][111] Aims and objectives of OPERA The overall aim of the OPERA study was to evaluate the impact of a whole-home intervention, consisting of training for residential and nursing home staff backed up with a twice-weekly, physiotherapist-led exercise class on depressive symptoms in care home residents. Specifically, we sought to test the effect of the OPERA intervention on:…”

Section: Process Evaluations Of Complex Interventionsmentioning

confidence: 99%

Exercise for depression in care home residents: a randomised controlled trial with cost-effectiveness analysis (OPERA)

Underwood

Lamb²,

Eldridge³

et al. 2013

Health Technol Assess

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Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 06/02/01. The contractual start date was in February 2008. The draft report began editorial review in January 2012 and was accepted for publication in July 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health.

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“…Process evaluation of clinical trials serves i) to investigate intervention delivery fidelity, ii) to evaluate the feasibility and efficacy of the program in daily practice, and iii) to identify areas for intervention refinement[21]. The overall STAR trial process evaluation is multi-faceted and includes the views of participants from the experimental group, seminar facilitators' views, practice background information, mapping of participants' use of the online learning program (e.g., log-in times and duration, or whether access takes place during working or leisure hours), STAR web forum contributions commenting on process and program content, and detailed economic evaluation.…”

Section: Introductionmentioning

confidence: 99%

Enhancing the quality of antibiotic prescribing in Primary Care: Qualitative evaluation of a blended learning intervention

et al. 2010

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BackgroundThe Stemming the Tide of Antibiotic Resistance (STAR) Educational Program aims to enhance the quality of antibiotic prescribing and raise awareness about antibiotic resistance among general medical practitioners. It consists of a seven part, theory-based blended learning program that includes online reflection on clinicians' own practice, presentation of research evidence and guidelines, a practice-based seminar focusing on participants' own antibiotic prescribing and resistance rates in urine samples sent from their practice, communication skills training using videos of simulated patients in routine surgeries, and participation in a web forum. Effectiveness was evaluated in a randomised controlled trial in which 244 GPs and Nurse Practitioners and 68 general practices participated. This paper reports part of the process evaluation of that trial.MethodsSemi-structured, digitally recorded, and transcribed telephone interviews with 31 purposively sampled trial participants analysed using thematic content analysis.ResultsThe majority of participants reported increased awareness of antibiotic resistance, greater self-confidence in reducing antibiotic prescribing and at least some change in consultation style and antibiotic prescribing behaviour. Reported practical changes included adopting a practice-wide policy of antibiotic prescription reduction. Many GPs also reported increased insight into patients' expectations, ultimately contributing to improved doctor-patient rapport. The components of the intervention put forward as having the greatest influence on changing clinician behaviour were the up-to-date research evidence resources, simple and effective communication skills presented in on-line videos, and presentation of the practice's own antibiotic prescribing levels combined with an overview of local resistance data.ConclusionParticipants regarded this complex blended learning intervention acceptable and feasible, and reported wide-ranging, positive changes in attitudes and clinical practice as a result of participating in the STAR Educational Program.Trial registrationCurrent Controlled Trials ISRCTN63355948

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Implications of process evaluation for clinical effectiveness and clinical practice in a trial on chronic shoulder complaints

Cited by 13 publications

References 21 publications

Development and feasibility of an intervention featuring individual supported work placements to aid return to work for unemployed people living with chronic pain

Development and feasibility of an intervention featuring individual supported work placements to aid return to work for unemployed people living with chronic pain

Exercise for depression in care home residents: a randomised controlled trial with cost-effectiveness analysis (OPERA)

Enhancing the quality of antibiotic prescribing in Primary Care: Qualitative evaluation of a blended learning intervention

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