Читать книгу Nursing and Health Interventions - Souraya Sidani - Страница 20

Interventions, complex or not, are delivered in real‐world context. The context includes the practice setting in which health professionals provide the interventions, and the environment in which clients apply the treatment recommendations. In either case, context is complex, characterized by variability on a multitude of factors, occurring at different levels (Chandler et al., 2016; Masterson‐Algar et al., 2018) and at different points in time (Cambon et al., 2019). The factors are embedded within the physical, psycho‐socio‐cultural, economic, and political setting or environment, and encountered at the micro (e.g. individual, home), meso (e.g. workplace, organization), or macro (e.g. healthcare system) levels. Contextual factors influence the implementation and the effectiveness of interventions (Craig et al., 2018). It, therefore, is essential to account for context in the design and evaluation of interventions. This can be achieved by: (1) engaging various stakeholder groups (e.g. clients, health professionals, decision‐makers) in the design and adaptation of interventions (Braithwaite et al., 2018; Greenwood‐Lee et al., 2016)—the groups are knowledgeable of the local context and provide valuable feedback on what factors are operating in that context, how to address the factors, and how to modify the intervention to enhance its fit with the features and resources available at the local context; and (2) incorporating a process evaluation within an intervention evaluation study (see Chapter 13) aimed to monitor the implementation of the intervention, examine its mechanism of action, and exploring if and how contextual factors affect interventions' implementation and effectiveness (Moore et al., 2019). The findings of a process evaluation are critical for the validity of a study's conclusions; specifically, they point to factors that contributed, positively or negatively, to the interventions' effects.