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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The practice of 'doing' evaluation: Lessons learned from nine complex intervention trials in action
Implementation Science, Volume 9, No. 1, Article 75, Year 2014
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Description
Background: There is increasing recognition among trialists of the challenges in understanding how particular 'real-life' contexts influence the delivery and receipt of complex health interventions. Evaluations of interventions to change health worker and/or patient behaviours in health service settings exemplify these challenges. When interpreting evaluation data, deviation from intended intervention implementation is accounted for through process evaluations of fidelity, reach, and intensity. However, no such systematic approach has been proposed to account for the way evaluation activities may deviate in practice from assumptions made when data are interpreted.Methods: A collective case study was conducted to explore experiences of undertaking evaluation activities in the real-life contexts of nine complex intervention trials seeking to improve appropriate diagnosis and treatment of malaria in varied health service settings. Multiple sources of data were used, including in-depth interviews with investigators, participant-observation of studies, and rounds of discussion and reflection.Results and discussion: From our experiences of the realities of conducting these evaluations, we identified six key 'lessons learned' about ways to become aware of and manage aspects of the fabric of trials involving the interface of researchers, fieldworkers, participants and data collection tools that may affect the intended production of data and interpretation of findings. These lessons included: foster a shared understanding across the study team of how individual practices contribute to the study goals; promote and facilitate within-team communications for ongoing reflection on the progress of the evaluation; establish processes for ongoing collaboration and dialogue between sub-study teams; the importance of a field research coordinator bridging everyday project management with scientific oversight; collect and review reflective field notes on the progress of the evaluation to aid interpretation of outcomes; and these approaches should help the identification of and reflection on possible overlaps between the evaluation and intervention.Conclusion: The lessons we have drawn point to the principle of reflexivity that, we argue, needs to become part of standard practice in the conduct of evaluations of complex interventions to promote more meaningful interpretations of the effects of an intervention and to better inform future implementation and decision-making. © 2014 Reynolds et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4079170/bin/1748-5908-9-75-S1.pdf
Authors & Co-Authors
Reynolds, Joanna
Unknown Affiliation
Diliberto, Deborah
Unknown Affiliation
Mangham-Jefferies, Lindsay
Unknown Affiliation
Ansah, Evelyn K.
Unknown Affiliation
Lal, Sham
Unknown Affiliation
Mbakilwa, Hilda
Unknown Affiliation
Bruxvoort, Katia J.
Unknown Affiliation
Webster, Jayne
Unknown Affiliation
Vestergaard, Lasse Skafte
Unknown Affiliation
Yeung, Shunmay M.
Unknown Affiliation
Leslie, Toby J.
Unknown Affiliation
Hutchinson, Eleanor
Unknown Affiliation
Reyburn, Hugh G.
Unknown Affiliation
Lalloo, David G.
Unknown Affiliation
Schellenberg, David M.
Unknown Affiliation
Cundill, Bonnie
Unknown Affiliation
Staedke, Sarah G.
Unknown Affiliation
Wiseman, Virginia
Unknown Affiliation
Goodman, Catherine A.
Unknown Affiliation
Chandler, Clare I.R.
Unknown Affiliation
Statistics
Citations: 51
Authors: 20
Affiliations: 8
Identifiers
Doi:
10.1186/1748-5908-9-75
e-ISSN:
17485908
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Grounded Theory
Case Study
Study Approach
Qualitative