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Contextual factors influencing the implementation of innovations in community-based primary health care: the experience of 12 Canadian research teams

  • Jenny Ploeg (a1), Sabrina T. Wong (a2), Kasra Hassani (a3), Marie-Lee Yous (a4), Martin Fortin (a5), Claire Kendall (a6), Clare Liddy (a7), Maureen Markle-Reid (a8), Bojana Petrovic (a9), Emilie Dionne (a10), Cathie M. Scott (a11) and Walter P. Wodchis (a12) (a13)...

Abstract

The objectives of this paper are to: (1) identify contextual factors such as policy that impacted the implementation of community-based primary health care (CBPHC) innovations among 12 Canadian research teams and (2) describe strategies used by the teams to address contextual factors influencing implementation of CBPHC innovations. In primary care settings, consideration of contextual factors when implementing change has been recognized as critically important to success. However, contextual factors are rarely recorded, analyzed or considered when implementing change. The lack of consideration of contextual factors has negative implications not only for successfully implementing primary health care (PHC) innovations, but also for their sustainability and scalability. For this evaluation, data collection was conducted using self-administered questionnaires and follow-up telephone interviews with team representatives. We used a combination of directed and conventional content analysis approaches to analyze the questionnaire and interview data. Representatives from all 12 teams completed the questionnaire and 11 teams participated in the interviews; 40 individuals participated in this evaluation. Four themes representing contextual factors that impacted the implementation of CBPHC innovations were identified: (I) diversity of jurisdictions (II) complexity of interactions and collaborations (III) policy, and (IV) the multifaceted nature of PHC. The teams used six strategies to address these contextual factors including: (1) conduct an environmental scan at the beginning (2) maintaining engagement among partners and stakeholders by encouraging open and inclusive communication; (3) contextualizing the innovation for different settings; (4) anticipating and addressing changes, delays, and the need for additional resources; (5) fostering a culture of research and innovation among partners and stakeholders; and (6) ensuring information about the innovation is widely available. Implementing CBPHC innovations across jurisdictions is complex and involves navigating through multiple contextual factors. Awareness of the dynamic nature of context should be considered when implementing innovations.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Prof. Jenny Ploeg, RN, PhD, Department of Health, Aging and Society, School of Nursing, Scientific Director, Aging, Community and Health Research Unit, Faculty of Health Sciences and Associate Member, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Email: ploegj@mcmaster.ca

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Contextual factors influencing the implementation of innovations in community-based primary health care: the experience of 12 Canadian research teams

  • Jenny Ploeg (a1), Sabrina T. Wong (a2), Kasra Hassani (a3), Marie-Lee Yous (a4), Martin Fortin (a5), Claire Kendall (a6), Clare Liddy (a7), Maureen Markle-Reid (a8), Bojana Petrovic (a9), Emilie Dionne (a10), Cathie M. Scott (a11) and Walter P. Wodchis (a12) (a13)...

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