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Contextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis

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dc.contributor.authorPeryer, Guy
dc.contributor.authorKelly, Sarah
dc.contributor.authorBlake, Jessica
dc.contributor.authorBurton, Jennifer K
dc.contributor.authorIrvine, Lisa
dc.contributor.authorCowan, Andy
dc.contributor.authorAkdur, Gizdem
dc.contributor.authorKillett, Anne
dc.contributor.authorBrand, Sarah L
dc.contributor.authorMusa, Massirfufulay Kpehe
dc.contributor.authorMeyer, Julienne
dc.contributor.authorGordon, Adam L
dc.contributor.authorGoodman, Claire
dc.contributor.orcidGoodman, Claire [0000-0002-8938-4893]
dc.date.accessioned2022-04-05T01:02:42Z
dc.date.available2022-04-05T01:02:42Z
dc.date.issued2022-03-01
dc.date.updated2022-04-05T01:02:41Z
dc.description.abstractAbstract <h4>Background</h4> Care homes are complex settings to undertake intervention research. Barriers to research implementation processes can threaten studies’ validity, reducing the value to residents, staff, researchers and funders. We aimed to (i) identify and categorise contextual factors that may mediate outcomes of complex intervention studies in care homes and (ii) provide recommendations to minimise the risk of expensive research implementation failures. <h4>Methods</h4> We conducted a systematic review using a framework synthesis approach viewed through a complex adaptive systems lens. We searched: MEDLINE, Embase, CINAHL, ASSIA databases and grey literature. We sought process evaluations of care home complex interventions published in English. Narrative data were indexed under 28 context domains. We performed an inductive thematic analysis across the context domains. <h4>Results</h4> We included 33 process evaluations conducted in high-income countries, published between 2005 and 2019. Framework synthesis identified barriers to implementation that were more common at the task and organisational level. Inductive thematic analysis identified (i) avoiding procedural drift and (ii) participatory action and learning as key priorities for research teams. Research team recommendations include advice for protocol design and care home engagement. Care home team recommendations focus on internal resources and team dynamics. Collaborative recommendations apply to care homes’ individual context and the importance of maintaining positive working relationships. <h4>Discussion</h4> Researchers planning and undertaking research with care homes need a sensitive appreciation of the complex care home context. Study implementation is most effective where an intervention is co-produced, with agreed purpose and adequate resources to incorporate within existing routines and care practices.
dc.identifier.doi10.17863/CAM.83208
dc.identifier.issn0002-0729
dc.identifier.otherPMC8887840
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335771
dc.languageeng
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.sourcenlmid: 0375655
dc.sourceessn: 1468-2834
dc.subjectComplexity
dc.subjectQualitative
dc.subjectOlder People
dc.subjectNursing Home
dc.subjectContext
dc.subjectHuman Factors
dc.subjectProcess Evaluation
dc.titleContextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis
dc.typeArticle
prism.issueIdentifier3
prism.publicationNameAge and ageing
prism.volume51
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.versionVoR

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