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Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework

BACKGROUND: The PACE ‘Steps to Success’ programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, this programme has been implemented in 37 LTCFs in 7 European countries. Alongs...

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Autores principales: Oosterveld-Vlug, Mariska, Onwuteaka-Philipsen, Bregje, ten Koppel, Maud, van Hout, Hein, Smets, Tinne, Pivodic, Lara, Tanghe, Marc, Van Den Noortgate, Nele, Hockley, Jo, Payne, Sheila, Moore, Danni Collingridge, Kijowska, Violetta, Szczerbińska, Katarzyna, Kylänen, Marika, Leppäaho, Suvi, Mercuri, Claudia, Rossi, Paola, Mercuri, Martina, Gambassi, Giovanni, Bassal, Catherine, de Paula, Emilie Morgan, Engels, Yvonne, Deliens, Luc, Van den Block, Lieve, Pasman, H. Roeline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924025/
https://www.ncbi.nlm.nih.gov/pubmed/31856882
http://dx.doi.org/10.1186/s13012-019-0953-8
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author Oosterveld-Vlug, Mariska
Onwuteaka-Philipsen, Bregje
ten Koppel, Maud
van Hout, Hein
Smets, Tinne
Pivodic, Lara
Tanghe, Marc
Van Den Noortgate, Nele
Hockley, Jo
Payne, Sheila
Moore, Danni Collingridge
Kijowska, Violetta
Szczerbińska, Katarzyna
Kylänen, Marika
Leppäaho, Suvi
Mercuri, Claudia
Rossi, Paola
Mercuri, Martina
Gambassi, Giovanni
Bassal, Catherine
de Paula, Emilie Morgan
Engels, Yvonne
Deliens, Luc
Van den Block, Lieve
Pasman, H. Roeline
author_facet Oosterveld-Vlug, Mariska
Onwuteaka-Philipsen, Bregje
ten Koppel, Maud
van Hout, Hein
Smets, Tinne
Pivodic, Lara
Tanghe, Marc
Van Den Noortgate, Nele
Hockley, Jo
Payne, Sheila
Moore, Danni Collingridge
Kijowska, Violetta
Szczerbińska, Katarzyna
Kylänen, Marika
Leppäaho, Suvi
Mercuri, Claudia
Rossi, Paola
Mercuri, Martina
Gambassi, Giovanni
Bassal, Catherine
de Paula, Emilie Morgan
Engels, Yvonne
Deliens, Luc
Van den Block, Lieve
Pasman, H. Roeline
author_sort Oosterveld-Vlug, Mariska
collection PubMed
description BACKGROUND: The PACE ‘Steps to Success’ programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, this programme has been implemented in 37 LTCFs in 7 European countries. Alongside an effectiveness study, a process evaluation study was conducted. This paper reports on the results of this process evaluation, of which the aim was to provide a more detailed understanding of the implementation of the PACE Programme across and within countries. METHODS: The process evaluation followed the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and involved various measures and tools, including diaries for country trainers, evaluation questionnaires for care staff, attendance lists and interviews (online and face-to-face, individual and in groups) with country trainers, managers, PACE coordinators and other staff members. Based on key elements of the PACE Programme, a priori criteria for a high, medium and low level of the RE-AIM components Reach, Adoption, Implementation and intention to Maintenance were defined. Qualitative data on factors affecting each RE-AIM component gathered in the online discussion groups and interviews were analysed according to the principles of thematic analysis. RESULTS: The performance of the PACE Programme on the RE-AIM components was highly variable within and across countries, with a high or medium score for in total 28 (out of 37) LTCFs on Reach, for 26 LTCFs on Adoption, for 35 LTCFs on Implementation and for 34 LTCFs on intention to Maintenance. The factors affecting performance on the different RE-AIM components could be classified into three major categories: (1) the PACE Programme itself and its way of delivery, (2) people working with the PACE Programme and (3) contextual factors. Several country-specific challenges in implementing the PACE Programme were identified. CONCLUSIONS: The implementation of the PACE Programme was feasible but leaves room for improvement. Our analysis helps to better understand the optimal levels of training and facilitation and provides recommendations to improve implementation in the LTC setting. The results of the process evaluation will be used to further adapt and improve the PACE Programme prior to its further dissemination. TRIAL REGISTRATION: The PACE study was registered at www.isrctn.com—ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) July 30, 2015.
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spelling pubmed-69240252019-12-30 Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework Oosterveld-Vlug, Mariska Onwuteaka-Philipsen, Bregje ten Koppel, Maud van Hout, Hein Smets, Tinne Pivodic, Lara Tanghe, Marc Van Den Noortgate, Nele Hockley, Jo Payne, Sheila Moore, Danni Collingridge Kijowska, Violetta Szczerbińska, Katarzyna Kylänen, Marika Leppäaho, Suvi Mercuri, Claudia Rossi, Paola Mercuri, Martina Gambassi, Giovanni Bassal, Catherine de Paula, Emilie Morgan Engels, Yvonne Deliens, Luc Van den Block, Lieve Pasman, H. Roeline Implement Sci Research BACKGROUND: The PACE ‘Steps to Success’ programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, this programme has been implemented in 37 LTCFs in 7 European countries. Alongside an effectiveness study, a process evaluation study was conducted. This paper reports on the results of this process evaluation, of which the aim was to provide a more detailed understanding of the implementation of the PACE Programme across and within countries. METHODS: The process evaluation followed the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and involved various measures and tools, including diaries for country trainers, evaluation questionnaires for care staff, attendance lists and interviews (online and face-to-face, individual and in groups) with country trainers, managers, PACE coordinators and other staff members. Based on key elements of the PACE Programme, a priori criteria for a high, medium and low level of the RE-AIM components Reach, Adoption, Implementation and intention to Maintenance were defined. Qualitative data on factors affecting each RE-AIM component gathered in the online discussion groups and interviews were analysed according to the principles of thematic analysis. RESULTS: The performance of the PACE Programme on the RE-AIM components was highly variable within and across countries, with a high or medium score for in total 28 (out of 37) LTCFs on Reach, for 26 LTCFs on Adoption, for 35 LTCFs on Implementation and for 34 LTCFs on intention to Maintenance. The factors affecting performance on the different RE-AIM components could be classified into three major categories: (1) the PACE Programme itself and its way of delivery, (2) people working with the PACE Programme and (3) contextual factors. Several country-specific challenges in implementing the PACE Programme were identified. CONCLUSIONS: The implementation of the PACE Programme was feasible but leaves room for improvement. Our analysis helps to better understand the optimal levels of training and facilitation and provides recommendations to improve implementation in the LTC setting. The results of the process evaluation will be used to further adapt and improve the PACE Programme prior to its further dissemination. TRIAL REGISTRATION: The PACE study was registered at www.isrctn.com—ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) July 30, 2015. BioMed Central 2019-12-19 /pmc/articles/PMC6924025/ /pubmed/31856882 http://dx.doi.org/10.1186/s13012-019-0953-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Oosterveld-Vlug, Mariska
Onwuteaka-Philipsen, Bregje
ten Koppel, Maud
van Hout, Hein
Smets, Tinne
Pivodic, Lara
Tanghe, Marc
Van Den Noortgate, Nele
Hockley, Jo
Payne, Sheila
Moore, Danni Collingridge
Kijowska, Violetta
Szczerbińska, Katarzyna
Kylänen, Marika
Leppäaho, Suvi
Mercuri, Claudia
Rossi, Paola
Mercuri, Martina
Gambassi, Giovanni
Bassal, Catherine
de Paula, Emilie Morgan
Engels, Yvonne
Deliens, Luc
Van den Block, Lieve
Pasman, H. Roeline
Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework
title Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework
title_full Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework
title_fullStr Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework
title_full_unstemmed Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework
title_short Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework
title_sort evaluating the implementation of the pace steps to success programme in long-term care facilities in seven countries according to the re-aim framework
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924025/
https://www.ncbi.nlm.nih.gov/pubmed/31856882
http://dx.doi.org/10.1186/s13012-019-0953-8
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