Health system context and implementation of evidence-based practices—development and validation of the context assessment for community health (COACH) tool for low- and middle-income settings

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dc.contributor.authorBergstrom, Annaen_ZA
dc.contributor.authorSkeen, Sarahen_ZA
dc.contributor.authorDuc, Duong M.en_ZA
dc.contributor.authorBlandon, Elmer Zelayaen_ZA
dc.contributor.authorEstabrooks, Caroleen_ZA
dc.contributor.authorGustavsson, Petteren_ZA
dc.contributor.authorHoa, Dinh Thi Phuongen_ZA
dc.contributor.authorKallestal, Carinaen_ZA
dc.contributor.authorMalqvist, Matsen_ZA
dc.contributor.authorNga, Nguyen Thuen_ZA
dc.contributor.authorPersson, Lars-Akeen_ZA
dc.contributor.authorPervin, Jesminen_ZA
dc.contributor.authorPeterson, Stefanen_ZA
dc.contributor.authorRahman, Anisuren_ZA
dc.contributor.authorSelling, Katarinaen_ZA
dc.contributor.authorSquires, Janet E.en_ZA
dc.contributor.authorTomlinson, Marken_ZA
dc.contributor.authorWaiswa, Peteren_ZA
dc.contributor.authorWallin, Larsen_ZA
dc.date.accessioned2017-01-25T11:25:00Z
dc.date.available2017-01-25T11:25:00Z
dc.date.issued2015-08-15
dc.date.updated2016-12-09T12:12:56Z
dc.descriptionCITATION: Bergstrom, A., et al. 2015. Health system context and implementation of evidence-based practices—development and validation of the context assessment for community health (COACH) tool for low- and middle-income settings. Implementation Science, 10:120, doi:10.1186/s13012-015-0305-2.
dc.descriptionThe original publication is available at http://implementationscience.biomedcentral.com
dc.description.abstractENGLISH ABSTRACT: Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in highincome settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaaraf_ZA
dc.description.urihttp://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0305-2
dc.description.versionPublisher's version
dc.format.extent15 pagesen_ZA
dc.identifier.citationBergstrom, A., et al. 2015. Health system context and implementation of evidence-based practices—development and validation of the context assessment for community health (COACH) tool for low- and middle-income settings. Implementation Science, 10:120, doi:10.1186/s13012-015-0305-2
dc.identifier.issn1748-5908 (Online)
dc.identifier.otherdoi:10.1186/s13012-015-0305-2
dc.identifier.urihttp://hdl.handle.net/10019.1/100525
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights.holderAuthor retains copyrighten_ZA
dc.subjectHealth systemen_ZA
dc.subjectMedical careen_ZA
dc.subjectHealth planningen_ZA
dc.subjectCommunity healthen_ZA
dc.titleHealth system context and implementation of evidence-based practices—development and validation of the context assessment for community health (COACH) tool for low- and middle-income settingsen_ZA
dc.typeArticleen_ZA
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