A Theoretically Informed Process Evaluation in Parallel to a Feasibility Study of a Complex Oral Health Intervention Using NICE Guidelines in a Care Home Setting

• DOI: 10.1111/cdoe.13016
• Publication Date: 2025-01-16T05:46:27Z
• Authors: Paul Brocklehurst; Joe Langley; Rebecca Wassall; Sana Daniyal; Saif Sayeed Syed; Michelle Harvey; Nia Goulden; Andrea Sherriff; Anja Heilmann; Zoe Hoare; Craig Smith; Richard Watt; Ciaran O'Neill; Frank Kee; Peter Cairns; Nat Lievesley; Gerald McKenna; Georgios Tsakos
• Keywords: Nice

A theoretically informed process evaluation was undertaken in parallel to a study examining the feasibility of an oral health intervention based on existing guideline for care homes. The objectives were explore factors that influenced implementation order understand potential pathway impact. research team initially utilised Pfadenhauer et al.'s framework, which focuses number different factors: characteristics, context, theory, process, strategy, agents, outcomes and setting. Nine semi-structured interviews with home managers staff, predominantly within arm study. Interview schedules originally framework. These coded analysed using thematic analysis. Given range themes emerged, ran reflexive workshop determine whether framework able capture frame authentic voice those interviewed. found systems lens approach better fitted data from interviews, capturing idiosyncrasy settings importance values beliefs key stakeholders. It clear unlike structure proposed by Pfaednhauer al., many interdependent hierarchical nature, is, paradigm goals had direct impact system structure, fed into how maintained, led onto actors behaved (care staff). also highlighted delivery: time poverty, competing needs, staff turnover, differences between shift patterns permanent agency staff. Cognitive capacity residents attitudes key. Adding enabled critically review change approach, explained nature findings. could influence intervention. ISRCTN10276613.