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Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study

BACKGROUND: This study aimed to evaluate the real-world implementation of the Friendship Bench (FB) – an evidence-based brief psychological intervention delivered by community health workers (CHWs) – three years after its implementation in three city health departments in Zimbabwe. Implementation si...

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Autores principales: Verhey, Ruth, Chitiyo, Charmaine, Mboweni, Sandra, Turner, Jean, Murombo, Gift, Healey, Andy, Chibanda, Dixon, Wagenaar, Bradley H., Araya, Ricardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682765/
https://www.ncbi.nlm.nih.gov/pubmed/36419089
http://dx.doi.org/10.1186/s12913-022-08767-9
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author Verhey, Ruth
Chitiyo, Charmaine
Mboweni, Sandra
Turner, Jean
Murombo, Gift
Healey, Andy
Chibanda, Dixon
Wagenaar, Bradley H.
Araya, Ricardo
author_facet Verhey, Ruth
Chitiyo, Charmaine
Mboweni, Sandra
Turner, Jean
Murombo, Gift
Healey, Andy
Chibanda, Dixon
Wagenaar, Bradley H.
Araya, Ricardo
author_sort Verhey, Ruth
collection PubMed
description BACKGROUND: This study aimed to evaluate the real-world implementation of the Friendship Bench (FB) – an evidence-based brief psychological intervention delivered by community health workers (CHWs) – three years after its implementation in three city health departments in Zimbabwe. Implementation sites were evaluated according to their current performance using the RE-AIM framework making this one of the first evaluations of a scaled-up evidence-based psychological intervention in sub-Saharan Africa (SSA). METHODS: Using the RE-AIM guide (www.re-aim.org), the authors designed quantitative indicators based on existing FB implementation data. Thirty-six primary health care clinics (PHC) in Harare (n=28), Chitungwiza (n=4) and Gweru (n=4) were included. Among these clinics 20 were large comprehensive health care centers, 7 medium (mostly maternal and child healthcare) and 9 small clinics (basic medical care and acting as referral clinic). Existing data from these clinics, added to additionally collected data through interviews and field observations were used to investigate and compare the performance of the FB across clinics. The focus was on the RE-AIM domains of Reach, Adoption, and Implementation. RESULTS: Small clinics achieved 34% reach, compared to large (15%) and medium clinics (9%). Adoption was high in all clinic types, ranging from 59% to 71%. Small clinics led the implementation domain with 53%, followed by medium sized clinics 43% and large clinics 40%. Small clinics performed better in all indicators and differences in performance between small and large clinics were significant. Program activity and data quality depends on ongoing support for delivering agents and buy-in from health authorities. CONCLUSION: The Friendship Bench program was implemented over three years transitioning from a research-based implementation program to one led locally. The Reach domain showed the largest gap across clinics where larger clinics performed poorly relative to smaller clinics and should be a target for future implementation improvements. Program data needs to be integrated into existing health information systems. Future studies should seek to optimize scale-up and sustainment strategies to maintain effective task-shared psychological interventions in SSA. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08767-9.
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spelling pubmed-96827652022-11-24 Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study Verhey, Ruth Chitiyo, Charmaine Mboweni, Sandra Turner, Jean Murombo, Gift Healey, Andy Chibanda, Dixon Wagenaar, Bradley H. Araya, Ricardo BMC Health Serv Res Research Article BACKGROUND: This study aimed to evaluate the real-world implementation of the Friendship Bench (FB) – an evidence-based brief psychological intervention delivered by community health workers (CHWs) – three years after its implementation in three city health departments in Zimbabwe. Implementation sites were evaluated according to their current performance using the RE-AIM framework making this one of the first evaluations of a scaled-up evidence-based psychological intervention in sub-Saharan Africa (SSA). METHODS: Using the RE-AIM guide (www.re-aim.org), the authors designed quantitative indicators based on existing FB implementation data. Thirty-six primary health care clinics (PHC) in Harare (n=28), Chitungwiza (n=4) and Gweru (n=4) were included. Among these clinics 20 were large comprehensive health care centers, 7 medium (mostly maternal and child healthcare) and 9 small clinics (basic medical care and acting as referral clinic). Existing data from these clinics, added to additionally collected data through interviews and field observations were used to investigate and compare the performance of the FB across clinics. The focus was on the RE-AIM domains of Reach, Adoption, and Implementation. RESULTS: Small clinics achieved 34% reach, compared to large (15%) and medium clinics (9%). Adoption was high in all clinic types, ranging from 59% to 71%. Small clinics led the implementation domain with 53%, followed by medium sized clinics 43% and large clinics 40%. Small clinics performed better in all indicators and differences in performance between small and large clinics were significant. Program activity and data quality depends on ongoing support for delivering agents and buy-in from health authorities. CONCLUSION: The Friendship Bench program was implemented over three years transitioning from a research-based implementation program to one led locally. The Reach domain showed the largest gap across clinics where larger clinics performed poorly relative to smaller clinics and should be a target for future implementation improvements. Program data needs to be integrated into existing health information systems. Future studies should seek to optimize scale-up and sustainment strategies to maintain effective task-shared psychological interventions in SSA. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08767-9. BioMed Central 2022-11-22 /pmc/articles/PMC9682765/ /pubmed/36419089 http://dx.doi.org/10.1186/s12913-022-08767-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Verhey, Ruth
Chitiyo, Charmaine
Mboweni, Sandra
Turner, Jean
Murombo, Gift
Healey, Andy
Chibanda, Dixon
Wagenaar, Bradley H.
Araya, Ricardo
Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study
title Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study
title_full Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study
title_fullStr Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study
title_full_unstemmed Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study
title_short Using the RE-AIM framework to evaluate the implementation of scaling-up the Friendship Bench in Zimbabwe – a quantitative observational study
title_sort using the re-aim framework to evaluate the implementation of scaling-up the friendship bench in zimbabwe – a quantitative observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682765/
https://www.ncbi.nlm.nih.gov/pubmed/36419089
http://dx.doi.org/10.1186/s12913-022-08767-9
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