Embedded implementation research determinants in Latin American health systems
DOI:
https://doi.org/10.11606/s1518-8787.2021055003027Keywords:
Public health systems research, Research support as topic, South-South Cooperation, Qualitative researchAbstract
OBJECTIVE: To assess the determinants of embedded implementation research (EIR) conduct in seven Latin American and Caribbean countries. METHODS: This qualitative interpretative study conducted and analyzed 14 semi-structured interviews based on a grounded theory approach using Atlas-ti© 7.5.7. We grouped the conditions appointed by interviewees as determinants of EIR conduct into six domains. RESULTS: The participation of high-level engaged decision makers as research co-producers is an important EIR determinant that fosters research use. Nevertheless, EIR faces challenges such as dealing with key personnel changes and fluctuating political contexts. CONCLUSIONS: Despite its limitations, EIR is effective in creating a sense of ownership of research results among implementers, which helps bridge the gap between research and decision-making in health system
References
Gagliardi AR, Kothari A, Graham ID. Research agenda for integrated knowledge translation (IKT) in healthcare: what we know and do not yet know. J Epidemiol Community Health. 2017;71(2):105-6.https://doi.org/10.1136/jech-2016-207743 [ Links ]
Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implement Sci. 2012;7(1):50. https://doi.org/10.1186/1748-5908-7-50 [ Links ]
McKibbon KA, Lokker C, Keepanasseril A, Colquhoun H, Haynes RB, Wilczynski NL. WhatisKT wiki: A case study of a platform for knowledge translation terms and definitions - descriptive analysis. Implement Sci. 2013;8(1):13. https://doi.org/10.1186/1748-5908-8-13 [ Links ]
Gagliardi AR, Fraser N, Wright FC, Lemieux-Charles L, Davis D. Fostering knowledge exchange between researchers and decision-makers: Exploring the effectiveness of a mixed-methods approach. Health Policy. 2008;86(1):53-63. https://doi.org/10.1016/j.healthpol.2007.09.002 [ Links ]
Alonge O, Rodriguez DC, Brandes N, Geng E, Reveiz L, Peters DH. How is implementation research applied to advance health in low-income and middle-income countries. BMJ Glob Heal. 2019;4(2):e001257. https://doi.org/10.1136/bmjgh-2018-001257 [ Links ]
Vindrola-Padros C, Pape T, Utley M, Fulop NJ. The role of embedded research in quality improvement: A narrative review. BMJ Qual Saf. 2017;26(1):70-80. https://doi.org/10.1136/bmjqs-2015-004877 [ Links ]
World Health Organization. WHO strategy on health policy and systems research: Changing mindsets. Geneva: World Health Organisation, 2012. 48 p. [ Links ]
Churruca K, Ludlow K, Taylor N, Long JC, Best S, Braithwaite J. The time has come: Embedded implementation research for health care improvement. J Eval Clin Pract. 2019;25(3):373-80. https://doi.org/10.1111/jep.13100 [ Links ]
Peters DH, Tran NT, Adam T. Implementation research in health: a practical guide. Geneva: World Health Organization, 2013. 69 p. [ Links ]
Fixsen D, Naoom S, Blasé K, Friedman R, Wallace F. Implementation Research: A Synthesis of the Literature. Tampa: University of South Floirda, Louis de la Parte Florida Mental Health Institute, 2005. 125 p. [ Links ]
Pan American Health Organization. IPIER (Improving Program Implementation through Embedded Research) [Internet]. Washington, D.C.: Pan American Health Organization, United Nations. Available from: https://www.paho.org/hq/index.php?option=com_content&view=article&id=11604:improving-program-implementation-through-embedded-research-ipier-program&Itemid=41011&lang=en [ Links ]
Tran N, Langlois E V, Reveiz L, Varallyay I, Elias V, Mancuso A, et al. Incorporación de las investigaciones para mejorar la ejecución de programas en América Latina y el Caribe. Rev Panam Salud Publica. 2017;41:75. [ Links ]
Langlois E V., Mancuso A, Elias V, Reveiz L. Embedding implementation research to enhance health policy and systems: a multi-country analysis from ten settings in Latin America and the Caribbean. Heal Res Policy Syst. 2019;17(1). https://doi.org/10.1186/s12961-019-0484-4 [ Links ]
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50. https://doi.org/10.1186/1748-5908-4-50 [ Links ]
Strauss A, Corbin J. Bases de la investigación cualitativa. Técnicas y procedimientos para desarrollar la teoría fundamentada. Medellín: Contus; 2002. [ Links ]
Federay J, Muir-Cochrane E. Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development. Int J Qual Methods. 2006;5(1). https://doi.org/10.1177/160940690600500107 [ Links ]
Meadows L, Morse J. Constructing evidence within the qualitative project. In: Morse J, Swanson J, Kuzel A, editors. The nature of evidence in qualitative inquiry. Riverside County: Sage; 2001. p. 187-202. [ Links ]
Alcalde-Rabanal JE, Becerril-Montekio VM, Langlois EV. Evaluation of Communities of Practice performance developing implementation research to enhance maternal health decision-making in Mexico and Nicaragua. Implement Sci. 2018;13(1):41. https://doi.org/10.1186/s13012-018-0735-8 [ Links ]
Bastos de Paula SH, Martins TA, Borges SMS, Nogueira CMO, Ramos VF. Evaluación de la implementación del protocolo de manejo de coinfección de tuberculosis y VIH en los servicios de asistencia especializada del estado de Ceará, Brasil. Rev Panam Salud Publica. 2017;41:1. [ Links ]
Klein K, Burrone MS, Alonso JP, Ares LR, Martí SG, Lavenia A, et al. Estrategia para mejorar el acceso al tratamiento etiológico para la enfermedad de Chagas en el primer nivel de atención en Argentina. Rev Panam Salud Publica. 2017;41. [ Links ]
Langlois EV., Montekio VB, Young T, Song K, Alcalde-Rabanal J, Tran N. Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches. Heal Res Policy Syst. 2016;14(1):20. https://doi.org/10.1186/s12961-016-0089-0 [ Links ]
Langlois E V, Tran NT, Ghaffar A, Reveiz L, Becerra-Posada F. Embedding research in health policy and systems in the Americas. Rev Panam Salud Publica. 2017;41:e68. https://doi.org/10.1136/bmj.k2469 [ Links ]
Simioni AT, Llanos O, Romero M, Ramos S, Brizuela V, Abalos E. Regionalization of perinatal health care in the province of Santa Fe, Argentina. Rev Panam Salud Publica. 2017;41:e38. [ Links ]
Velázquez M, Pacheco A, Silva M, Sosa D. Evaluation of the teleconsultation process from the perspective of the provider (Oaxaca Telehealth Program, Mexico). Rev Panam Salud Publica. 2017;41:e22. https://doi.org/10.26633/RPSP.2017.22 [ Links ]
Herrera P, Fajreldin V, Rodríguez MF, Kraemer P, Mendoza C, Pineda I, et al. Clinical practice guidelines: qualitative study of their implementation in the Chilean health system. Rev Panam Salud Publica. 2017;41:e67. https://doi.org/10.26633/RPSP.2017.67 [ Links ]
Reich MR. The politics of reforming health policies. Promot Educ. 2002;9(4):138-42. https://doi.org/10.1177/175797590200900401 [ Links ]
García-Fernández L, Benites C, Huamán B. Access barriers to comprehensive care for people affected by tuberculosis and human immunodeficiency virus coinfection in Peru, 2010-2015. Rev Panam Salud Publica. 2017;41:e23. [ Links ]
Tinajeros F, Ares LR, Elías V, Reveiz L, Sánchez F, Mejía M, et al. Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes network. Rev Panam Salud Publica. 2017;41:e21. [ Links ]
Moreno JHR, Vergara AJR, De Moya DJD, Jaramillo Rojas HJ, Díaz Rojas CM, Ciapponi A. Evaluation of tools for the implementation of clinical practice guidelines on sexually transmitted infections. Rev Panam Salud Publica. 2017;41:e49. [ Links ]
Ramírez GR, Bravo PE, Vivaldi MIM, Manríquez IP, Pérez TG. Adolescents’ access to contraception: perceptions of health workers in Huechuraba, Chile. Rev Panam salud publica. 2017;41:e77. [ Links ]
Published
Issue
Section
License
Copyright (c) 2021 Rodrigo García-Cerde, Victor Becerril-Montekio, Étienne Langlois, Ludovic Reveiz, Jacqueline Alcalde-Rabanal, Pilar Torres-Pereda
This work is licensed under a Creative Commons Attribution 4.0 International License.
