Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol

Abstract

IntroductionIntegrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project. The specific goals of the process and scale-up evaluation are to (1) analyse how, and to what extent, the roadmap has been implemented, (2) assess how the differing contexts can influence the implementation process of the scale-up strategies and (3) assess the progress of the scale-up.Methods and analysisA comprehensive framework was developed to include process and scale-up evaluation embedded in implementation science theory. Key implementation outcomes include acceptability, feasibility, relevance, adaptation, adoption and cost of roadmap activities. A diverse range of predominantly qualitative tools—including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping—were developed to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. The role of context is considered relevant, and barriers and facilitators to scale-up will be continuously assessed.Ethics and disseminationEthical approval has been obtained from the Institutional Review Board (ref. 1323/19) at the Institute of Tropical Medicine (Antwerp, Belgium). The SCUBY Project presents a comprehensive framework to guide the process and scale-up evaluation of complex interventions in different health systems. We describe how implementation outcomes, mechanisms of impact and scale-up outcomes can be a basis to monitor adaptations through a co-creation process and to guide other scale-up interventions making use of knowledge translation and co-creation activities.

Country-specific roadmaps for scaling up integrated care in Belgium, Slovenia, and Cambodia - Lessons learned from the SCUBY project

“…This article can be considered part of the process evaluation, assessing the process of implementing roadmaps to scale-up integrated care in each context. (10) In this study, we take a qualitative approach in examining this process within each country case.…”

Patient Co-Creation Initiatives in the Ambulatory Care Setting during COVID-19: A Systematic Review

“…In Norway, the challenge of an ageing population and declining birth rates have led to a shift in government policies. These policies now encourage collaboration between municipalities and volunteers, emphasizing coproduction as a method to harness resources effectively [8]. This collaboration can amplify resources and stimulate creativity through diversified dialogues and problem-solving, provided the assumptions, attitudes, and beliefs of each partnering entity are considered [13].…”

“…Co-creation in healthcare research augments the quality-of-care delivery and can have a positive influence on patient health outcomes [6,8,15,18]. By fostering collective collaboration among stakeholders, particularly patients, the healthcare system can gather crucial data, formulate new strategies, and shape public health discussions [21,23,26].…”

“…By fostering collective collaboration among stakeholders, particularly patients, the healthcare system can gather crucial data, formulate new strategies, and shape public health discussions [21,23,26]. The primary objective of co-creation is to render healthcare services more patient-centric [8,9]. This involves researching issues, devising and enacting interventions, and defining outcomes in collaboration with patients, family carers, professionals, researchers, and other key stakeholders.…”