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

Peryer, Guy ORCID:, Kelly, Sarah, Blake, Jessica, Burton, Jennifer K., Irvine, Lisa, Cowan, Andy, Akdur, Gizdem, Killett, Anne ORCID:, Brand, Sarah L., Musa, Massirfufulay Kpehe Musa, Meyer, Julienne, Gordon, Adam L. and Goodman, Claire (2022) Contextual factors influencing complex intervention research processes in care homes: A systematic review and framework synthesis. Age and Ageing, 51 (3). ISSN 0002-0729

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Background: 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. Methods: 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. Results: We included 33 process evaluations conducted in high-income countries, published between 2005-2019. 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. Discussion: 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.

Item Type: Article
Additional Information: Funding: This study/project is funded by the National Institute for Health Research (NIHR) Health Service Research and Delivery programme (HS&DR NIHR127234) and supported by the NIHR Applied Research Collaboration (ARC) East of England. CG is a NIHR Senior Investigator. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Uncontrolled Keywords: complexity,context,human factors,nursing home,older people,process evaluation,qualitative,ageing,geriatrics and gerontology ,/dk/atira/pure/subjectarea/asjc/1300/1302
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Institute for Volunteering Research
Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: LivePure Connector
Date Deposited: 16 Nov 2021 01:45
Last Modified: 19 Oct 2023 03:08
DOI: 10.1093/ageing/afac014


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