'A priori' external contextual factors and relationships with process indicators: a mixed methods study of the pre-implementation phase of 'Communities in Charge of Alcohol'.
Alcohol harm
Community health champion
Lay involvement
Pre-implementation context
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
29 11 2022
29 11 2022
Historique:
received:
31
08
2021
accepted:
20
10
2022
entrez:
29
11
2022
pubmed:
30
11
2022
medline:
2
12
2022
Statut:
epublish
Résumé
It is widely recognised that complex public health interventions roll out in distinct phases, within which external contextual factors influence implementation. Less is known about relationships with external contextual factors identified a priori in the pre-implementation phase. We investigated which external contextual factors, prior to the implementation of a community-centred approach to reducing alcohol harm called 'Communities in Charge of Alcohol' (CICA), were related to one of the process indicators: numbers of Alcohol Health Champions (AHCs) trained. A mixed methods design was used in the pre-implementation phase of CICA. We studied ten geographic communities experiencing both high levels of deprivation and alcohol-related harm in the North West of England. Qualitative secondary data were extracted from pre-implementation meeting notes, recorded two to three months before roll-out. Items were coded into 12 content categories using content analysis. To create a baseline 'infrastructure score', the number of external contextual factors documented was counted per area to a maximum score of 12. Descriptive data were collected from training registers detailing training numbers in the first 12 months. The relationship between the baseline infrastructure score, external contextual factors, and the number of AHCs trained was assessed using non-parametric univariable statistics. There was a positive correlation between baseline infrastructure score and total numbers of AHCs trained (R Data suggest that there were four key components that significantly influenced establishing an Alcohol Health Champion programme in areas experiencing both high levels of deprivation and alcohol-related harm. There is added value of capturing external contextual factors a priori and then testing relationships with process indicators to inform the effective roll-out of complex interventions. Future research could explore a wider range of process indicators and outcomes, incorporating methods to rate individual factors to derive a mean score. ISRCTN81942890, date of registration 12/09/2017.
Sections du résumé
BACKGROUND
It is widely recognised that complex public health interventions roll out in distinct phases, within which external contextual factors influence implementation. Less is known about relationships with external contextual factors identified a priori in the pre-implementation phase. We investigated which external contextual factors, prior to the implementation of a community-centred approach to reducing alcohol harm called 'Communities in Charge of Alcohol' (CICA), were related to one of the process indicators: numbers of Alcohol Health Champions (AHCs) trained.
METHODS
A mixed methods design was used in the pre-implementation phase of CICA. We studied ten geographic communities experiencing both high levels of deprivation and alcohol-related harm in the North West of England. Qualitative secondary data were extracted from pre-implementation meeting notes, recorded two to three months before roll-out. Items were coded into 12 content categories using content analysis. To create a baseline 'infrastructure score', the number of external contextual factors documented was counted per area to a maximum score of 12. Descriptive data were collected from training registers detailing training numbers in the first 12 months. The relationship between the baseline infrastructure score, external contextual factors, and the number of AHCs trained was assessed using non-parametric univariable statistics.
RESULTS
There was a positive correlation between baseline infrastructure score and total numbers of AHCs trained (R
CONCLUSIONS
Data suggest that there were four key components that significantly influenced establishing an Alcohol Health Champion programme in areas experiencing both high levels of deprivation and alcohol-related harm. There is added value of capturing external contextual factors a priori and then testing relationships with process indicators to inform the effective roll-out of complex interventions. Future research could explore a wider range of process indicators and outcomes, incorporating methods to rate individual factors to derive a mean score.
TRIAL REGISTRATION
ISRCTN81942890, date of registration 12/09/2017.
Identifiants
pubmed: 36447172
doi: 10.1186/s12889-022-14411-2
pii: 10.1186/s12889-022-14411-2
pmc: PMC9708132
doi:
Banques de données
ISRCTN
['ISRCTN81942890']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2224Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© 2022. The Author(s).
Références
Am J Public Health. 2011 Nov;101(11):2059-67
pubmed: 21940916
Implement Sci. 2011 Oct 06;6:116
pubmed: 21974914
BMC Public Health. 2020 Jul 2;20(1):1050
pubmed: 32615957
BMJ. 2018 Sep 19;362:k3928
pubmed: 30232084
BMC Med. 2010 Oct 20;8:63
pubmed: 20961442
BMC Public Health. 2018 Apr 19;18(1):522
pubmed: 29673337
Perspect Public Health. 2013 Mar;133(2):96-103
pubmed: 22891049
BMJ. 2018 Sep 21;362:k4028
pubmed: 30242071
Health Soc Care Community. 2022 Sep;30(5):e2737-e2749
pubmed: 35040220
BMJ Open. 2020 Aug 26;10(8):e036044
pubmed: 32847905
J Adv Nurs. 2008 Apr;62(1):107-15
pubmed: 18352969
Lancet. 2017 Apr 15;389(10078):1558-1580
pubmed: 27919442
Health Place. 2021 Mar;68:102504
pubmed: 33571897
BMJ. 2020 May 20;369:m1987
pubmed: 32434792
BMC Public Health. 2022 Mar 31;22(1):627
pubmed: 35354448
BMJ. 2019 May 8;365:l2099
pubmed: 31068328
Addiction. 2017 Jun;112(6):968-1001
pubmed: 28220587
Qual Health Res. 2005 Nov;15(9):1277-88
pubmed: 16204405
Addiction. 2007 Sep;102(9):1335-9
pubmed: 17697267
Prev Med. 2017 Aug;101:156-170
pubmed: 28601621
Drug Alcohol Rev. 2020 May;39(4):301-304
pubmed: 32358884
Lancet. 2018 Sep 22;392(10152):1015-1035
pubmed: 30146330
BMJ. 2021 Sep 30;374:n2061
pubmed: 34593508
Front Public Health. 2020 Mar 03;8:59
pubmed: 32195217
Cochrane Database Syst Rev. 2005 Jan 25;(1):CD004015
pubmed: 15674924
J Epidemiol Community Health. 2014 Feb;68(2):101-2
pubmed: 24022816
Lancet. 2019 Jun 22;393(10190):2493-2502
pubmed: 31076174
BMC Health Serv Res. 2018 Mar 27;18(1):209
pubmed: 29580251
J Clin Nurs. 2013 May;22(9-10):1332-42
pubmed: 23170849
BMJ Open. 2019 Aug 15;9(8):e029954
pubmed: 31420394
Int J Drug Policy. 2021 Dec;98:103412
pubmed: 34461410
Qual Health Res. 2016 Nov;26(13):1802-1811
pubmed: 27340178
Promot Educ. 2007;Suppl 2:17-22
pubmed: 17685075