Abstract

BackgroundIn order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention.MethodsA qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation.ResultsThe stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations.ConclusionThis article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the insight of healthcare professionalnd managers and emphasizes the need to intervene at different levels. Further research will be needed in order to develop a more thorough understanding of the impacts of such strategies on the final outcomes of intervention implementations.

Highlights

  • In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals

  • Interventions should be tailored to the target setting and the target professionals [3,11,12]

  • Participants were recruited for interviews in order to identify their current practices, perceived issues, and broad expectations regarding elderly care

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Summary

Introduction

In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. It has been recommended that the context be investigated and potential users be involved in the intervention development process in order to tailor the intervention to local conditions and incorporate user perspectives [1,5,11,16,17,18] While this strategy is generally recognized as a condition for successful implementations, and even if some uncertainties remain [12,18,19], pre-intervention diagnostic analyses of the context and the needs of potential users are rarely performed. Even when a pre-implementation study is performed, most interventions do not incorporate its specific findings into the design of the intervention itself [12,20]

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