Table 3 Use of a theory, model and/or framework to guide implementation (n = 14)
From: Implementation science in maternity care: a scoping review
Category | Publication | Nation | Aim | Design and/or method | Participants | Theory, model or framework | Use |
|---|---|---|---|---|---|---|---|
Determinant frameworks | [192] | Morocco | ‘understand the implementation process by identifying the characteristics of this intervention and the dimensions of the three systems which could act as barriers to/facilitators of the implementation process’ | Case study (document analysis, focus groups, interviews, observation of educational sessions) | • Administrators (medical administration officers, administrative nurse cadres, health programmer), clinicians (consultant, midwives, nurses, obstetricians, physicians), managers (academic directors, medical directors nurse managers, midwifery managers and representatives), students, women (n = 107) | Consolidated framework for implementation research | Analyse qualitative data |
[191] | Australia | ‘explore the enablers and barriers to implementation of the Australian smoking cessation in pregnancy guidelines’ | Interviews | • Managers (obstetric, midwifery = 8), clinicians (midwives, obstetricians = 19; total = 27) | Theoretical domains framework | Identify implementation barriers | |
[190] | Kenya | ‘describes and analyses the implementation process, its strengths and challenges, and the lessons gained’ | Mixed-methods (case narratives, document analysis, focus groups, interviews) | • Clinicians (community health workers, doctors, matrons, nurses), managers (district health program managers, coordinators), policymakers, professional association representatives (medical, nursing), women who delivered at the service in the last 6 months (interviews: n = 122) • Community leaders, community members, women who delivered at the service in the last 6 months (focus groups: n = 98) • Women who delivered at the service in the last 6 months (case narratives: n = 65) | Consolidated framework for implementation research | Analyse qualitative data | |
[193] | Australia | ‘describes the perceptions that midwives and nurses have about the BFHI [Baby Friendly Health Initiative] and examines factors that may facilitate or hinder the implementation process’ | Focus groups | • Clinicians (child and family nurses, midwives, neonatal nurses), managers (clinical consultants, midwifery and child and family health nursing managers), student midwives (n = 132) | Diffusion of innovations model | Analyse qualitative data | |
[189] | Australia | ‘systematically assess evidence-practice gap in the multidisciplinary management of overweight and obesity… in pregnancy to inform an intervention to facilitate translating obesity guidelines into practice in a tertiary maternity service’ | Survey | • Clinicians (dieticians, midwives, obstetricians, physiotherapists; n = 84) | Theoretical domains framework | Analyse qualitative data | |
Implementation theories | [195] | Australia | ‘discuss how theory can be used to explore, understand and interpret implementation strategies and the impact of organisational context when evaluating new models of health service delivery’ | Case studies | • RCT one: midwives (n = 8), women (n = 1000) • RCT two: midwives (n = 12), women (n = 2314) | Normalisation process model | Analyse qualitative data |
[186] | United Kingdom | ‘develop an intervention to improve the quality and content of place of birth discussions between midwives and low-risk women and to evaluate this intervention in practice’ | Mixed-methods (focus groups, interviews, questionnaires, midwife feedback visits, workshops) | • Stage 1: midwives (n = 38) • Stage 2: midwives (n = 58) • Stage 3: midwives (n = 66) | Capability, opportunity, motivation and behaviour (COM-B) | Guide intervention design | |
[196] | United Kingdom | Gauge the ‘acceptability of the system changes to staff, as well as aids and hindrances to implementation and normalization of this complex intervention’ | Process evaluation (interviews, observation) | • Maternity staff (n = 60), staff who deliver smoking cessation services (n = 39), staff of other organisations (n = 4; total = 103) | Normalisation process theory | Analyse qualitative data | |
[194] | United Kingdom | ‘explore the benefits, barriers and disadvantages of implementing an electronic record system (ERS). The extent that the system has become ‘normalised’ into routine practice was also explored’ | Interviews | • Healthcare staff (doctors, healthcare assistants, midwives; total = 19) | Normalisation process theory | Analyse qualitative data | |
Classic theories | [198] | Spain | ‘develop an instrument to measure variables that influence health care professionals’ behaviour with regard to the protection, promotion, and support of breastfeeding, especially one that related to the Baby-Friendly Hospital Initiative (BFHI), and to conduct a psychometric assessment’ | Cross-sectional using a questionnaire | • Multidisciplinary working group that developed the questionnaire included (preventive medicine and public health physicians = 2; psychologists = 2; midwife=1; nurse = 1; paediatrician n = 1) • Expert groups that reviewed the questionnaire (clinicians=20; psychologists = 12; nurses = 6; paediatricians = 5; midwives = 3; general practitioners = 2) • Maternity and primary care clinicians who completed the questionnaire, including midwives, nurses, nursing assistants, physicians (n = 201) | Theory of reasoned action | Inform questionnaire development |
[197] | Australia | ‘understand clinician factors that may influence the up- take, acceptance and use of the NLBB [Normal Labour and Birth Bundle]’ | Mixed-methods (two focus groups, survey) | • Maternity care clinicians (midwives, consultant obstetricians, residents and registrars; n = 74) | Theory of planned behaviour | Analyse qualitative data | |
Evaluation framework | [199] | Zambia | ‘explore perspectives, roles, achievements and challenges of the Safe Motherhood Action Groups (SMAG) programme in Kalomo, Zambia’ | Interviews | • Action group members (n = 22), community leaders (n = 5), husbands (n = 3), manager (n = 1), mothers (n = 10), nurses (n = 5; total = 46) | PRECEDE-PROCEED | Analyse qualitative data |
Process model | [200] | United States | ‘set forth a new patient-centred implementation model informed by a qualitative study that explored women’s decisions, perceptions, and experiences of elective induction of labour’ | Interviews | • Pregnant women (n = 29) | Ottawa model of research use (OMRU) framework | Analyse qualitative data |
Additional framework | [201] | United Kingdom | Gauge the feasibility of implementing a maternity care intervention | Case study (pre-implementation survey, development and deployment of an implementation plan) | • Postnatal women (n = 250) | Stages of implementation framework | Describe and guide the translation of research into practice |