Using the consolidated Framework for Implementation Research to integrate innovation recipients’ perspectives into the implementation of a digital version of the spinal cord injury health maintenance tool: a qualitative analysis

BMC Health Services Research, 2024 · DOI: https://doi.org/10.1186/s12913-024-10847-x · Published: March 11, 2024

Simple Explanation

This study addresses the challenges in developing community health strategies for individuals with spinal cord injury (SCI) by focusing on the implementation of the SCI Health Maintenance Tool (SCI-HMT). The tool was co-designed with people living with SCI and their General Practitioners (GPs) in NSW, Australia. The research uses the Consolidated Framework for Implementation Research (CFIR) to gather and analyze qualitative data from innovation recipients to improve the implementation of the SCI-HMT during its digitization into a website and App. The study emphasizes the importance of integrating the perspectives of people with SCI and GPs in the implementation process to promote equity and ensure the SCI-HMT effectively meets their needs.

Study Duration

2018-2023

Participants

23 innovation recipients, 6 health professionals, and 4 people with SCI

Evidence Level

Not specified

Key Findings

1
The study found that self-management of SCI is demanding, and the SCI-HMT needs to balance complexity with accessibility by mixing expert clinical information with lived experience knowledge.
2
The research highlighted the importance of engaging with SCI peer support networks and primary and tertiary care providers to maximize uptake of the SCI-HMT.
3
The findings underscored the need for a productive partnership between GPs and individuals with SCI to address the demands of long-term self-management, facilitated by digital diaries and care plans within the SCI-HMT.

Research Summary

The study aimed to integrate the perspectives of innovation recipients in the implementation of a digital version of the Spinal Cord Injury Health Maintenance Tool (SCI-HMT) using the Consolidated Framework for Implementation Research (CFIR). Data from 23 innovation recipients were coded to inform a semi-structured interview guide, which was then used to explore barriers and facilitators with health professionals and people with SCI. Reflective statements were created and linked to actionable findings to improve the implementation plan. The study concluded that understanding recipient perspectives is essential when developing implementation strategies for healthcare innovations and that the revised CFIR provided an effective method to integrate and value these perspectives in the SCI-HMT development.

Practical Implications

Improved SCI-HMT Design

Balancing scientific evidence and clinical expertise with lived experience knowledge in the SCI-HMT to create a more accessible and engaging platform.

Enhanced Healthcare Partnerships

Fostering productive partnerships between GPs and individuals with SCI through digital diaries and care plans to improve communication and proactive health management.

Targeted Implementation Strategies

Engaging SCI community groups, primary and tertiary care providers to maximize the uptake of SCI-HMT at all points of care, from rehabilitation onwards.

Study Limitations

1
The study did not test any implementation strategies to impact determinants, mechanisms, or outcomes.
2
The relatively small sample size of participants may not allow for saturation and generalizability of the findings.
3
Future research could examine the interaction between certain demographic differences (e.g., gender) of people with SCI and potential barriers and facilitators to the implementation of the SCI-HMT.

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