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Ethnographic process evaluation in primary care: explaining the complexity of implementation

Overview of attention for article published in BMC Health Services Research, December 2014
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Mentioned by

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4 tweeters

Citations

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36 Dimensions

Readers on

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105 Mendeley
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Title
Ethnographic process evaluation in primary care: explaining the complexity of implementation
Published in
BMC Health Services Research, December 2014
DOI 10.1186/s12913-014-0607-0
Pubmed ID
Authors

Arwen E Bunce, Rachel Gold, James V Davis, Carmit K McMullen, Victoria Jaworski, MaryBeth Mercer, Christine Nelson

Abstract

BackgroundThe recent growth of implementation research in care delivery systems has led to a renewed interest in methodological approaches that deliver not only intervention outcome data but also deep understanding of the complex dynamics underlying the implementation process. We suggest that an ethnographic approach to process evaluation, when informed by and integrated with quantitative data, can provide this nuanced insight into intervention outcomes. The specific methods used in such ethnographic process evaluations are rarely presented in detail; our objective is to stimulate a conversation around the successes and challenges of specific data collection methods in health care settings. We use the example of a translational clinical trial among 11 community clinics in Portland, OR that are implementing an evidence-based, health-information technology (HIT)-based intervention focused on patients with diabetes.DiscussionOur ethnographic process evaluation employed weekly diaries by clinic-based study employees, observation, informal and formal interviews, document review, surveys, and group discussions to identify barriers and facilitators to implementation success, provide insight into the quantitative study outcomes, and uncover lessons potentially transferable to other implementation projects. These methods captured the depth and breadth of factors contributing to intervention uptake, while minimizing disruption to clinic work and supporting mid-stream shifts in implementation strategies. A major challenge is the amount of dedicated researcher time required.SummaryThe deep understanding of the `how¿ and `why¿ behind intervention outcomes that can be gained through an ethnographic approach improves the credibility and transferability of study findings. We encourage others to share their own experiences with ethnography in implementation evaluation and health services research, and to consider adapting the methods and tools described here for their own research.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 105 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 2%
United Kingdom 1 <1%
Colombia 1 <1%
Unknown 101 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 24 23%
Student > Ph. D. Student 16 15%
Student > Master 15 14%
Student > Doctoral Student 6 6%
Student > Bachelor 6 6%
Other 21 20%
Unknown 17 16%
Readers by discipline Count As %
Medicine and Dentistry 27 26%
Social Sciences 22 21%
Nursing and Health Professions 14 13%
Psychology 7 7%
Computer Science 5 5%
Other 10 10%
Unknown 20 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 December 2014.
All research outputs
#13,290,504
of 21,321,193 outputs
Outputs from BMC Health Services Research
#4,722
of 7,085 outputs
Outputs of similar age
#178,360
of 345,124 outputs
Outputs of similar age from BMC Health Services Research
#330
of 502 outputs
Altmetric has tracked 21,321,193 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,085 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one is in the 30th percentile – i.e., 30% of its peers scored the same or lower than it.
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We're also able to compare this research output to 502 others from the same source and published within six weeks on either side of this one. This one is in the 29th percentile – i.e., 29% of its contemporaries scored the same or lower than it.