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Table 1 The degree of flexibility in SPIRIT intervention components and subcomponents

From: Figuring out fidelity: a worked example of the methods used to identify, critique and revise the essential elements of a contextualised intervention in health policy agencies

Intervention components (fixed) Subcomponents Targeted participants Degree of flexibility in form and contenta
1. Audit, feedback and goal setting a. Feedback forum Senior leaders and other key managers, as determined by each agency Partial: Tailored presentation based on agency’s audit data. Informal discussion shaped by participants’ interests.
b. Intervention selection
c. Identification of other strategies
d. Mid-intervention feedback
e. SPIRIT newsletter All agency staff involved in policy/program work Partial: Tailored to each agency based on their audit data
2. Leadership program a. Supporting organisational use of evidence Senior leaders and other managers depending on size and configuration of agency Partial: Standardised presentation determined in consultation with providers, but with agency-specific case examples. Discussion shaped by participants’ interests.
b. Leading organisational change
3. Organisational support for research a. Quarterly email endorsement of SPIRIT from agency’s CEO All agency staff involved in policy/program work Partial: Proforma text that CEOs can adapt
b. Access to WebCIPHER (an interactive research portal) Limited: Web CIPHER is an online knowledge exchange community providing news, events, research, reviews and resources relevant to health policy.
c. Resources for improving the agency’s use of research None: Agencies were given the same generic resources.
4. Opportunity to test systems for accessing research and reviews (brokered services) a. Brokered commission of:
­ a rapid systematic review OR
­ an evaluation plan OR
­ an analysis of linked data
Primary: Agency-selected staff who would benefit from experience commissioning a service. Secondary: all staff working in the topic area addressed by the commissioned product Extensive: Standard brokerage processes are used but agencies choose the product, and specify the topic and how it should be approached to best meet their needs.
5. Research access Three occasions of research access from two modes: All policy/program staff working in the topic area covered by the forum Extensive: Agencies choose the topic. They can nominate a particular provider and negotiate the form of the session. Providers shape the delivery details.
a. Interactive forums with researchers AND/OR
b. Summary of systematic reviews All policy/program staff working in the topic area covered by the review Partial: Agencies choose the topic
6. Educational symposia for staff a. Valuing research symposium All agency staff involved in policy/program work Limited: Agencies can nominate case examples
b. Two symposia from:
­ Access to research
­ Appraising research
­ Evaluation
­ Working with researchers
All policy/program staff who might benefit from enhanced skills in the techniques covered Partial: Agencies select symposia topics from the menu. They can tailor the focus, nominate case examples and providers, and negotiate the form of the session. Providers shape the delivery details.
  1. aIn all cases agencies had the scope to negotiate session dates, times, duration (between 1-2 hours) and attendance