Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10348
Title: Bridging the knowledge-practice gap in tuberculosis contact management in a high-burden setting: a mixed-methods protocol for a multicenter health system strengthening study.
Authors: Lestari, Trisasi
Graham, Steve
van den Boogard, Christel
Triasih, Rina
Poespoprodjo, Jeanne Rini
Ubra, Reynold Rizal
Kenangalem, Enny
Mahendradhata, Yodi
Anstey, Nicholas M
Bailie, Ross S
Ralph, Anna P
Affiliation: Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia. trisasilestari@gmail.com.. Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia. trisasilestari@gmail.com..
Centre for International Child Health, Department of Paediatrics and Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia.. Burnet Institute, Melbourne, Australia..
Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia..
Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia..
Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.. Papuan Health and Community Development Foundation, Papua, Indonesia..
Mimika District Health Authority, Papua, Indonesia..
Papuan Health and Community Development Foundation, Papua, Indonesia..
Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia..
Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
University Centre for Rural Health, School of Medicine, University of Sydney, Lismore, Australia..
Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Issue Date: 19-Mar-2019
Citation: Implementation science : IS 2019-03-19; 14(1): 31
Abstract: People in close contact with tuberculosis should have screening and appropriate management, as an opportunity for active case detection and prevention. However, implementation of tuberculosis contact screening and management is limited in high-burden settings. Behaviour change is needed across three levels of the healthcare system-policymakers, healthcare providers, and patients. To bridge the wide policy-practice gap, this study draws on the Consolidated Framework for Implementation Research, the Behaviour Change Wheel, and the RE-AIM model (Reach, Effectiveness, Adoption, Implementation, Maintenance) to respectively understand barriers, implement change, and evaluate process and outcome. This methods paper describes a mixed-methods intervention study in Eastern Indonesia. Quantitative data will be collected during baseline, intervention, and sustainability periods and analyzed using time series analysis. The primary outcome is the number of individuals completing tuberculosis preventive therapy by the end of the two-year intervention phase. Of an estimated 10,000 contacts during this period, we anticipate that a minimum of 416 will be found to have active TB or will complete preventive therapy. Qualitative data (semi-structured interviews, focus group discussions, and observations) will be collected from consenting healthcare providers, patients, and contacts. Activities to promote policy implementation include healthcare provider training, quarterly continuous quality improvement workshops, a social media discussion forum, and promotional materials. The Consolidated Framework for Implementation Research will be used to identify reasons for limited policy implementation at baseline. The Behaviour Change Wheel will be used to ensure that a suitable range of activities are implemented to facilitate change. The RE-AIM model will be used as the evaluation framework. Use of theoretical frameworks in combination can ensure a comprehensive understanding of, and robust response to, health policy underimplementation. The selected frameworks are highly applicable to this pragmatic intervention study, in a setting where End TB Strategy targets will not be met without substantial behavior change within health systems. Continuous quality improvement cycles will provide a way to engage staff and stakeholders in understanding local data to motivate behavior change. If successful, up to 500 people could be prevented from developing complications of tuberculosis through early case-finding or receiving preventive therapy over a two-year period. Australian New Zealand Clinical Trials Register 375803 .
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10348
DOI: 10.1186/s13012-019-0870-x
ORCID: http://orcid.org/0000-0002-4799-5338
Type: Journal Article
Subjects: Behaviour Change Wheel
Consolidated Framework for Implementation Research
Preventive treatment
RE-AIM model
Tuberculosis contact investigation
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