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  • Kate Seers
    University of Warwick
  • Joanne Rycroft-Malone
  • Karen Cox
    Fontys University of Applied Sciences, Eindhoven
  • Nicola Crichton
    London South Bank University
  • Rhiannon Edwards
  • A.C. Eldh
    Linköping University
  • C.A. Estabrooks
    University of Alberta
  • Gill Harvey
    University of Adelaide
  • Claire Hawkes
    University of Warwick
  • Carys Jones
  • Alison Kitson
    University of Adelaide
  • Brendan McCormack
    Queen Margaret University
  • Christel McMullan
    University of Birmingham
  • Carole Mockford
    University of Warwick
  • Theo Niessen
    Fontys University of Applied Sciences, Eindhoven
  • Paul Slater
    University of Ulster
  • Angie Titchen
    University of Ulster
  • Teatske van der Zijp
    Fontys University of Applied Sciences, Eindhoven
  • Lars Walling
    Karolinska Institute, Stockholm

Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test whether two different approaches to facilitating implementation could affect the use of research evidence in practice.

A pragmatic clustered randomised controlled trial with embedded process and economic evaluation was used. The study took place in four European countries across 24 long-term nursing care sites, for people aged 60 years or more with documented urinary incontinence. In each country, sites were randomly allocated to standard dissemination, or one of two different types of facilitation. The primary outcome was the documented percentage compliance with the continence recommendations, assessed at baseline, then at 6, 12, 18, and 24 months after the intervention.

Data were analysed using STATA15, multi-level mixed-effects linear regression models were fitted to scores for compliance with the continence recommendations, adjusting for clustering.

Quantitative data were obtained from reviews of 2313 records. There were no significant differences in the primary outcome (documented compliance with continence recommendations) between study arms and all study arms improved over time.

This was the first cross European randomised controlled trial with embedded process evaluation that sought to test different methods of facilitation. There were no statistically significant differences in compliance with continence recommendations between the groups. It was not possible to identify whether different types and “doses” of facilitation were influential within very diverse contextual conditions. The process evaluation (Rycroft-Malone et al., Implementation Science. doi: 10.1186/s13012-018-0811-0) revealed the models of facilitation used were limited in their ability to overcome the influence of contextual factors.
Original languageEnglish
Article number137
JournalImplementation Science
Publication statusPublished - 16 Nov 2018

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