Abstract
BackgroundProfessional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners’ complex real-world practice settings while preserving the core components of those programs’ models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site.MethodsThis paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization.ResultsWhile each team developed a unique pattern of implementing the activities, all the program’s core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process.ConclusionsThis paper shows how a professional development program model can be adapted to different contexts while preserving its core components. Capturing the heterogeneity of the intervention’s exposure, as was done here, will make possible in-depth impact analyses involving, for example, the testing of program–context interactions to identify program outcomes predictors. Such work is essential to advance knowledge on the action mechanisms of professional development programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0903-3) contains supplementary material, which is available to authorized users.
Highlights
Professional development is a key component of effective public health infrastructures
The findings presented here show that a health promotion professional development program aimed at local public health organizations can be successfully tailored to different settings without compromising its core components
In this article we have explored the question of implementation fidelity and adaptation of a professional development program in health promotion
Summary
Professional development is a key component of effective public health infrastructures. Professional development programs in public health and health promotion must adapt to practitioners’ complex real-world practice settings while preserving the core components of those programs’ models and theoretical bases. Professional development programs must be adaptable to different real-world practice settings while preserving the core components of their model. The CSSS structure was created as part of the province’s 2004 health reform [23], when 95 CSSSs were created in Quebec, including 12 in Montreal The mandate of these new organizations is to integrate the public health and the healthcare sectors using a population-based approach across a continuum of services ranging from health promotion all the way to palliative care [23]. Starting in 2010, the HPL was gradually implemented in partnership with seven CSSSs in the Montreal region
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