Towards a programme theory for fidelity in the evaluation of complex interventions

• DOI: 10.1111/jep.12174
• Publication Date: 2014-05-19T10:01:34Z
• Authors: Patricia Masterso...; Christopher R. Bu...; Jo Rycroft‐Malone; Catherine M. Sackley; Marion F. Walker
• Keywords: Stroke Rehabilitation; Models, Theoretical; United Kingdom; Nursing Homes; 03 medical and health sciences; Outcome and Process Assessment, Health Care; 0302 clinical medicine; Occupational Therapy; Activities of Daily Living; Humans; Learning Curve; Qualitative Research

This paper addresses the challenge of investigating fidelity in implementation a complex rehabilitation intervention designed to increase level independence personal activities daily living stroke patients UK care homes. A programme theory was constructed underpin process evaluation running alongside cluster randomized trial intervention.The has been drawing on principles realist evaluation. Using data from in-depth semi-structured interviews (n = 17) with all occupational therapists (OTs) and critical incident reports 20), frameworks for implementation, developed.The incorporates four potential mechanisms through which within can be investigated. These areas are (1) balancing research professional requirements that performed number while delivering study interventions; (2) OTs rapport building home staff; (3) work focused re-engineering environments patients; (4) learning about context its impacts over time.These findings characterize real-world nature research, specifically negotiated clinical settings, including individual patients' needs. adds evidence base because current neglect importance time individuals across span trial.