Third-sector Organizations Research Articles

The Value of Routinely Collected Data in Evaluating Home Assessment and Modification Interventions to Prevent Falls in Older People: Systematic Literature Review.

BackgroundFalls in older people commonly occur at home. Home assessment and modification (HAM) interventions can be effective in reducing falls; however, there are some concerns over the validity of evaluation findings. Routinely collected data could improve the quality of HAM evaluations and strengthen their evidence base.ObjectiveThe aim of this study is to conduct a systematic review of the evidence of the use of routinely collected data in the evaluations of HAM interventions.MethodsWe searched the following databases from inception until January 31, 2020: PubMed, Ovid, CINAHL, OpenGrey, CENTRAL, LILACS, and Web of Knowledge. Eligible studies were those evaluating HAMs designed to reduce falls involving participants aged 60 years or more. We included study protocols and full reports. Bias was assessed using the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool.ResultsA total of 7 eligible studies were identified in 8 papers. Government organizations provided the majority of data across studies, with health care providers and third-sector organizations also providing data. Studies used a range of demographic, clinical and health, and administrative data. The purpose of using routinely collected data spanned recruiting and creating a sample, stratification, generating independent variables or covariates, and measuring key study-related outcomes. Nonhome-based modification interventions (eg, in nursing homes) using routinely collected data were not included in this study. We included two protocols, which meant that the results of those studies were not available. MeSH headings were excluded from the PubMed search because of a reduction in specificity. This means that some studies that met the inclusion criteria may not have been identified.ConclusionsRoutine data can be used successfully in many aspects of HAM evaluations and can reduce biases and improve other important design considerations. However, the use of these data in these studies is currently not widespread. There are a number of governance barriers to be overcome to allow these types of linkage and to ensure that the use of routinely collected data in evaluations of HAM interventions is exploited to its full potential.

Dealing With Paradoxes, Manufacturing Governance: Organizational Change in European Third-Sector Organizations

Third-sector organizations (TSOs) in Europe have been confronted with profound changes to their regulatory and societal environments. By applying the concepts of “organizational paradoxes” and “governance,” we analyze how TSOs have adjusted their governance as a response to these environmental challenges. Based on organizational case studies in France, Germany, and the Netherlands, we argue that TSOs have found multiple ways to address tensions at the organizational level, for example, by mobilizing and combining resources, re-arranging their organizational governance and by adopting new legal forms. These changes have resulted in hybridization and increased organizational complexity that might translate into the emergence of new paradoxes at the organizational level. Therefore, dealing with paradoxes constitutes an ongoing process for TSOs that goes beyond incremental adjustments.

Civil Society Organizations and Labour Market Integration for Refugees and Asylum Seekers in Greece

The 2015 crisis of refugee policies saw an upgrade in the role of civil society organizations (CSOs) as service providers for the migrant population in Greece. CSOs attempted to substitute for the government’s failure to provide a migration policy designed for the social integration of migrants, refugees and asylum seekers (MRAs). As a result, they have been overseeing a majority of services related to the integration of MRAs in the labour market. This paper aims to enrich the underdeveloped so far discussion on the role of CSOs in the integration of refugees and asylum seekers (RAs) into the Greek labour market. This will be attempted by adopting a qualitative approach. The paper is based on 34 interviews done in 2019, involving refugees, asylum seekers and representatives of third-sector organizations, namely non-governmental organizations (NGOs) and grassroots solidarity initiatives (GSIs) provide various activities that seek to improve the employability of refugees and asylum seekers and help them navigate the employment policies. The article concludes that the lack of a follow-up to the various actions, the fragmented funding schemes and the absence of a clear integration policy from public actors and support from the public administration lie behind the relatively limited role played by CSOs for refugees and asylum seekers in labour market integration.

Percentage tax designation institutions. On Sugden\u2019s contractarian account

“Percentage Tax Designation Institutions”, also known as “Percentage Philanthropy Laws”, are fiscal institutions through which taxpayers can freely designate a certain percentage of their income tax to organizations whose main activity is of public interest: churches, third-sector organizations, political parties, etc. A comprehensive explanation of such systems is still lacking. In The Community of Advantage, Robert Sugden provides an original theoretical account of the Italian “8 × 1000” institution as one of those forms of regulation that “would be justified as ways of expanding opportunity for mutually beneficial transactions” and, more particularly, as a liberal and “contractarian approach to the provision of public goods”. This article is an attempt to expand and deepen the understanding not only of the 8 × 1000 but also of the 5 × 1000 and 2 × 1000 institutions, by reflecting on and possibly refining Sugden’s contractarian account, at least with regard to the part that relies on and develops the voluntary exchange tradition (Wicksell, Lindahl and Buchanan). To remain faithful to two normative premises of Sugden’s approach—the opportunity criterion and the correlated freedom of choice—we must introduce some theoretical adjustments to take into due account the way in which taxpayers’ freedoms—not only freedom of choice but also autonomy—are affected by default rules and the related redistribution procedures. In addition, these institutions also go beyond the voluntary exchange tradition—insofar as they go beyond its basic assumptions: the benefit principle of taxation, taxpayers’ self-interest and the very logic of exchange—and, at the same time, they can be read as a new form of voluntary tax justice.

Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

BackgroundFrom late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition to accommodating new guidelines and policies, staff had to adjust to rapid reconfiguration of services external to the home that they would normally depend upon for support. This study examined the complex interdependencies of support as staff responded to COVID-19. The aim was to inform more effective responses to the ongoing pandemic, and to improve understanding of how to work with care home staff and organisations after the pandemic has passed.MethodsTen managers of registered care homes in the East Midlands of England were interviewed by videoconference or phone about their experiences of the crisis from a structured organisational perspective. Analysis used an adapted organisational framework analysis approach with a focus on social ties and interdependencies between organisations and individuals.ResultsThree key groups of interdependencies were identified: care processes and practice; resources; and governance. Care home staff had to deliver care in innovative ways, making high stakes decisions in circumstances defined by: fluid ties to organisations outside the care home; multiple, sometimes conflicting, sources of expertise and information; and a sense of deprioritisation by authorities. Organisational responses to the pandemic by central government resulted in resource constraints and additional work, and sometimes impaired the ability of staff and managers to make decisions. Local communities, including businesses, third-sector organisations and individuals, were key in helping care homes overcome challenges. Care homes, rather than competing, were found to work together to provide mutual support. Resilience in the system was a consequence of dedicated and resourceful staff using existing local networks, or forging new ones, to overcome barriers to care.ConclusionsThis study identified how interdependency between care home organisations, the surrounding community, and key statutory and non-statutory organisations beyond their locality, shaped decision making and care delivery during the pandemic. Recognising these interdependencies, and the expertise shown by care home managers and staff as they navigate them, is key to providing effective healthcare in care homes as the pandemic progresses, and as the sector recovers afterwards.

Identifying Suicide and Self-Harm Research Priorities in North West England.

Background: Understanding and effectively managing self-harm and suicide require collaborative research between stakeholders focused on shared priorities. Aims: We aimed to develop a consensus about suicide and self-harm research priorities in the North West of England using the Delphi method. Method: Items for the Delphi survey were generated through group discussions at a workshop with 88 stakeholders and subsequent thematic analysis of key themes. A total of 44 participants who were experts-by-experience, researchers, and clinicians based within health services including third-sector organizations completed the Delphi survey. Results: A three-round survey reached consensus on 55 research priority items identifying key priorities in each of the following groups: offenders, children and young people, self-harm in community settings, and crisis care in the community. Limitations: The pool of delegates at the workshop and subsequent self-selection into the Delphi may have introduced bias into the study. Conclusion: The current paper highlights specific actionable priorities were identified in four areas that can be used to inform research efforts and future policy and practice, based on shared areas of perceived importance and concern. Future work is needed to confirm the significance of these priority areas, including the use of evidence synthesis approaches to ascertain the extent to which these priorities have already been investigated and where gaps in understanding remain.

Marginal Players? The Third Sector and Employability Services for Migrants, Refugees and Asylum Seekers in the UK

Literature in the field of employability and the third sector has focused upon the impact of marketisation on third sector providers, elaborating how commissioning processes have led to a contraction of (smaller) third sector organisations (TSOs) and an expansion of larger private sector bodies. Extant research does not however explore the role of third sector organisations in the employability of migrants, refugees and asylum seekers. Therefore, our paper explores this gap by adopting a qualitative approach via a total of 36 interviews involving migrants, refugees, asylum seekers and managers of third sector organisations, alongside a categorisation of TSOs. Our findings reveal that TSOs are the primary (and for asylum seekers perhaps the only) providers of integration support services and training or education services. We found that only a limited number of organisations provide formal employability services or skills development services which seem to be only residual in terms of the range of activities that TSOs can organise. Thus, perhaps the main function that TSOs perform that enables integration into the UK labour market is providing a safe and trusted environment that people can use to increase their confidence, improve their well-being, broaden their social circle, learn the language or increase their work experience.

The Role of Knowledge, Self-Efficacy, and Social Support in Self-Care Behaviors among Diabetic Patients: A Meta-Analysis

Background: Diabetes mellitus is recognized as one of the emerging public health problems globally, in which the number of cases and prevalence have been steadily increasing over the past few decades. To reduce the burden posed to health systems and afflicted individuals, patients need to adopt self-care practices. At the same time, some studies found knowledge, self-efficacy, and support were essential. Hence, this meta-analysis aimed to assess these predictors of self-care behaviors among diabetic patients. Subjects and Method: This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a systematic search in electronic databases for observational studies about knowledge, self-efficacy, and family or social support for diabetic self-care behaviors published between 2012 and 2022. The Joanna Briggs Institute’s Critical Appraisal tool was used. For statistical analysis such as I-squared and Begg and Egger’s tests, the Review Manager (RevMan) 5.3 software was employed. Tables and forest plots were presented with 95% confidence intervals (CI). Statistical significance was declared at a p-value < 0.05. Results: Twelve studies with 5,482 participants were included. Good self-care behaviors were significantly associated with adequate diabetic knowledge (AOR= 2.22; 95% CI= 1.24 to 3.98; p= 0.007) and having family or social support (AOR= 2.5; 95% CI= 1.98 to 3.16; p<0.001), whereas poor self-efficacy was a significant predictor of poor self-care behaviors (AOR= 2.46; 95% CI= 1.66 to 3.65; p<0.001). Conclusion: Diabetic knowledge, self-efficacy, and family or social support are essential correlates and predictors of self-care behaviors. Researchers, healthcare professionals, third-sector organizations, and policymakers can use these findings to re-evaluate. Keywords: diabetes, self-care behaviors, knowledge, self-efficacy, social support, meta-analysis Correspondence: Ayu Nanda Sari. Faculty of Medicine, Universitas Malikussaleh. Jl. H. Meunasah Uteunkot Cunda, Lhokseumawe 24351, Aceh, Indonesia. Email: ayunandasari@student.uns.ac.id. Mobile: +62852­10688872. Journal of Health Promotion and Behavior (2021), 06(03): 250-262 DOI: https://doi.org/10.26911/thejhpb.2021.06.03.08

Community-Centers in Israel during the COVID-19 Pandemic<br/>—A Collective Impact

The COVID-19 epidemic is a natural disaster crisis on a global scale. Despite the extensive experience in emergency operations that the Israeli community-centers have accumulated during times of war, community centers were required to develop original methods in order to make their services accessible to the communities, especially in these times of social distance and quarantines. This study examined the implementation of three collaboration models that enabled joint action whether multi or single sector, using the unique assets of each sector or organization. Three models of collaborations aimed at producing a common social impact were examined: 1) The wisdom of the crowd; 2) Strategic cross-sectoral partnerships; and 3) Collective impact. Qualitative data was collected from community centers in five local authorities, in an attempt to determine which model was the most influential in the community centers’ performance throughout the crisis. Interviews were conducted with ten senior managers in the community, as the performance of community centers throughout the pandemic was highly dynamic and could best be captured using this method. Results showed that the model of Collective Impact provided the most desired outcomes among the investigated models. Another important finding highlights the importance of the managers’ experience in the community centers’ performance. Based on these findings, conclusions and recommendations for future operations of third-sector organizations were drawn.

“We'll go back to a system you really do not like!” Organizational norms and structural violence in a British foodbank

PurposeWe explore how neoliberal logic has led to an erosion of social-welfare programs and pervades organizational structures and functions of a third-sector organization. Based upon fieldwork in a foodbank in the North-West of England, we discuss the impact of economic cuts upon organizational norms of the foodbank, and the intersection with the provision of charity support and personal relationships between the staff, volunteers and visitors.Design/methodology/approachThis article analyses pervasiveness of neoliberalism on a foodbank and the impact this has on organizational norms and relationships found within the organization. It integrates themes of structural violence, neoliberal discourse in the charity sector, notions of (un)deservingness and appropriate of time.FindingsOur research finds how a hostile environment transpires in a third-sector organization under increased economic and bureaucratic pressures and from this, organizational rules emerge that ignore the lived experiences of the people it serves. Herein, visitors must learn the organization's norms and garner relationships to be able to navigate the organization to successfully access essential resources.Originality/valueThe findings in this article will be of interest to academics researching poverty and organizational norms, professionals in the charity-sector and policy makers. Rules originating from economic and bureaucratic pressures can establish barriers to accessing essential material resources. It informs the pressures felt in balancing access to support services with personal timetables, and the need to include visitors' voices in establishing norms.

Reducing food waste and food insecurity in the UK: The architecture of surplus food distribution supply chain in addressing the sustainable development goals (Goal 2 and Goal 12.3) at a city level

The paradox that tonnes of food is wasted while people go hungry has raised concern from national and international authorities. In developed countries, reducing these problems has focused on surplus food distribution as a ‘win-win’ solution contributing to sustainable development goals. While the existing literature acknowledges the role of third-sector organisations, research on the supply chain of surplus food distribution and the coordination among actors is limited. This research explores actors and organisations in the value chain of surplus food distribution at the city level. Based on semi-structured interviews and participant observation, our findings highlight the need for a coordinated effort between actors as an essential arrangement to capture the value of surplus food. Despite the close cooperation, hierarchical power relationships exist between organisations in the supply chain. We unpack challenges in the surplus food supply chain, such as lack of a legislative framework for food donations and organisational sustainability issues that have forced third-sector organisations to work independently to reduce the uncertainties of food quality and quantity. We shed light on the practical implications by highlighting how multiple stakeholders could improve the efficiency of surplus food distribution.

How do third sector organisations or charities providing health and well-being services in England implement patient-reported outcome measures (PROMs)? A qualitative interview study

ObjectivesTo identify the facilitators and barriers to implementing patient-reported outcome measures (PROMs) in third sector organisations (TSOs) delivering health and well-being services.DesignA qualitative interview study. Participants were recruited using purposive,...

Mental health, smoking and poverty: benefits of supporting smokers to quit.

Smoking rates among people with common mental health conditions remain around 50% higher than those in the wider population; this is a significant cause of the 10-20-year reduced life expectancy of people with mental health conditions. However, the effects of smoking go far beyond physical health. Research estimates that smokers with mental health conditions could be spending as much as £2200 a year on tobacco, pushing an estimated 130 000 people with a common mental disorder into poverty. The Government has set a target for England to be smokefree by 2030; however, without a dramatic increase in support, smokers with mental health conditions risk being left behind. Action on Smoking and Health provides the secretariat for the Mental Health & Smoking Partnership. The Partnership aims to reduce the inequality in smoking rates between people with mental health conditions and the wider population. It brings together Royal Colleges, third-sector organisations, trade unions and academia to review progress and highlight areas for further action.

UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework

Background Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers ( n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group ( n = 39). Revisions were undertaken until consensus was reached. Results Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24 .

Diversity as discourse and diversity as practice: critical reflections on migrant women’s experiences of accessing mental health support in London

ABSTRACT The paper critically examines the way diversity is conceptualised as a dominant discourse and as a paradigm for understanding the present, which has gradually replaced multiculturalism in academic and policy discourse. Using our interviews with third sector practitioners providing mental health support to a wealth of migrant populations in London, the paper offers key examples of how TSOs (Third Sector Organisations) address migrant women’s diverse needs, showing how diversity is practised in the everyday of community groups. This paper’s novelty consists in exposing overlaps and divergences between diversity discourses and diversity practices and its added value lays in the combination of academic and practitioner perspectives in the study of TSOs supporting migrant, refugee and asylum seeker women in London.

Comunicación publicitaria en medios digitales

La gestión de la Responsabilidad Social Organizacional (RSO) dentro de las Organizaciones del Tercer Sector (OTS) permite que se proyecten como organizaciones éticas y congruentes comprometidas con sus públicos, el entorno y la comunidad. La comunicación publicitaria en medios digitales favorece una adecuada gestión estratégica de la RSO para sensibilizar a sus públicos y obtener su apoyo. En esta investigación se analiza si las OTS de México, Chile, España e Inglaterra utilizan la comunicación publicitaria en sus páginas web para dar a conocer el modo en que asumen la RSO. Se miden tres variables de la RSO: comportamiento ético, medio ambiente y cambio climático y contribución a la comunidad, mediante un análisis de contenido. Los resultados muestran que las OTS de Inglaterra son las que más utilizan este tipo de comunicación publicitaria para dar a conocer sus acciones de RSO en comparación con las de México. No obstante, las organizaciones de los cuatro países tienen retos importantes para fortalecer su RSO y su comunicación publicitaria digital. Principalmente deben comprender que la correcta gestión de RSO y de la comunicación publicitariaen medios digitales fortalece su reputación y confianza con sus públicos.

Reflections on effective services: the art of evidence-based programming

Third sector organisations (TSOs) are playing an increasingly prominent role in delivering health and social care services to the public. It is therefore important to ensure that such services are safe, equitable and effective. One way to achieve this is by incorporating evidence-based programmes (EBPs) and research into practice. Drawing on the broad literature, this article examines the values and knowledge preferences of TSOs and how these influence the incorporation of EBPs and related activities. Also discussed are the various factors that have an impact on successful EBP adoption and evidence use in the third sector and ways to maximise TSOs’ knowledge use. Informed by the perspective of a community-based mental health worker and academic researchers who engage in knowledge translation with TSOs, this discussion provides implications for practice and future research. Two recommendations are proposed: greater understanding of the knowledge-to-action pipeline; and the exploration and study of collaborations between TSOs and researchers.

Evaluating alcohol intoxication management services: the EDARA mixed-methods study

Background Front-line health-care services are under increased demand when acute alcohol intoxication is most common, which is in night-time environments. Cities have implemented alcohol intoxication management services to divert the intoxicated away from emergency care. Objectives To evaluate the effectiveness, cost-effectiveness and acceptability to patients and staff of alcohol intoxication management services and undertake an ethnographic study capturing front-line staff’s views on the impact of acute alcohol intoxication on their professional lives. Methods This was a controlled mixed-methods longitudinal observational study with an ethnographic evaluation in parallel. Six cities with alcohol intoxication management services were compared with six matched control cities to determine effects on key performance indicators (e.g. number of patients in the emergency department and ambulance response times). Surveys captured the impact of alcohol intoxication management services on the quality of care for patients in six alcohol intoxication management services, six emergency departments with local alcohol intoxication management services and six emergency departments without local alcohol intoxication management services. The ethnographic study considered front-line staff perceptions in two cities with alcohol intoxication management services and one city without alcohol intoxication management services. Results Alcohol intoxication management services typically operated in cities in which the incidence of acute alcohol intoxication was greatest. The per-session average number of attendances across all alcohol intoxication management services was low (mean 7.3, average minimum 2.8, average maximum 11.8) compared with the average number of emergency department attendances per alcohol intoxication management services session (mean 78.8), and the number of patients diverted away from emergency departments, per session, required for services to be considered cost-neutral was 8.7, falling to 3.5 when ambulance costs were included. Alcohol intoxication management services varied, from volunteer-led first aid to more clinically focused nurse practitioner services, with only the latter providing evidence for diversion from emergency departments. Qualitative and ethnographic data indicated that alcohol intoxication management services are acceptable to practitioners and patients and that they address unmet need. There was evidence that alcohol intoxication management services improve ambulance response times and reduce emergency department attendance. Effects are uncertain owing to the variation in service delivery. Limitations The evaluation focused on health service outcomes, yet evidence arose suggesting that alcohol intoxication management services provide broader societal benefits. There was no nationally agreed standard operating procedure for alcohol intoxication management services, undermining the evaluation. Routine health data outcomes exhibited considerable variance, undermining opportunities to provide an accurate appraisal of the heterogenous collection of alcohol intoxication management services. Conclusions Alcohol intoxication management services are varied, multipartner endeavours and would benefit from agreed national standards. Alcohol intoxication management services are popular with and benefit front-line staff and serve as a hub facilitating partnership working. They are popular with alcohol intoxication management services patients and capture previously unmet need in night-time environments. However, acute alcohol intoxication in emergency departments remains an issue and opportunities for diversion have not been entirely realised. The nurse-led model was the most expensive service evaluated but was also the most likely to divert patients away from emergency departments, suggesting that greater clinical involvement and alignment with emergency departments is necessary. Alcohol intoxication management services should be regarded as fledgling services that require further work to realise benefit. Future work Research could be undertaken to determine if a standardised model of alcohol intoxication management services, based on the nurse practitioner model, can be developed and implemented in different settings. Future evaluations should go beyond the health service and consider outcomes more generally, especially for the police. Future work on the management of acute alcohol intoxication in night-time environments could recognise the partnership between health-care, police and ambulance services and third-sector organisations in managing acute alcohol intoxication. Trial registration Current Controlled Trials ISRCTN63096364. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 24. See the NIHR Journals Library website for further project information.

Work–family interface and job satisfaction: The role of affective commitment

Objective: this research was to analyze if any of the types of organizational commitment mediated the relationship between work–family interface and job satisfaction. To that end, an empirical, quantitative and cross-sectional study was designed, framed within the guidelines of an associative–explanatory approach. Method: the study variables were measured using a set of validated instruments with adequate psychometric properties. The study population consisted of a non-probabilistic convenience sample of 376 workers (191 males and 185 females) from third-sector organizations, due to their importance in the current working world. Results: the results showed that affective commitment partially mediates the relationships between the dimensions work–family interface (enrichment and conflict) and job satisfaction. This type of commitment emerges as a mediational construct between job satisfaction and the possibilities of dealing with the demands from different vital spheres. Such mechanism may be explained through the role stress theory and the social exchange theory. Conclusions: these findings might be useful when it comes to designing family– friendship policies in order to retain human talent and promote affective bonds between employees and organizations. Authorship contribution The work has been carried out entirely by the Author.

Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness

BackgroundThe implementation of complex interventions experiences challenges that affect the extent to which they become embedded and scaled-up. Implementation at scale in complex environments like community settings defies universal replication. Planning for implementation in such environments requires knowledge of organisational capacity and structure. Pre-implementation work is an important element of the early phase of preparing the setting for the introduction of an intervention, and the factors contributing towards the creation of an optimal pre-implementation community context are under-acknowledged.MethodsTo explore the factors contributing towards the creation of an optimal pre-implementation context, a quasi-ethnographic approach was taken. The implementation of a social network intervention designed to tackle loneliness in a community setting acts as the case in example. Observations (of meetings), interviews (with community partners) and documentary analysis (national and local policy documents and intervention resources) were conducted. Layder’s adaptive theory approach was taken to data analysis, with the Consolidated Framework for Implementation Research (CFIR) and a typology of third-sector organisations used to interpret the findings.ResultsCommunity settings were found to sit along a continuum with three broad categories defined as Fully Professionalised Organisations; Aspirational Community, Voluntary and Social Enterprises; and Non-Professionalised Community-Based Groups. The nature of an optimal pre-implementation context varied across these settings. Using the CFIR, the results illustrate that some settings were more influenced by political landscape (Fully professional and Aspirational setting) and others more influenced by their founding values and ethos (Non-Professionalised Community-Based settings). Readiness was achieved at different speeds across the categories with those settings with more resource availability more able to achieve readiness (Fully Professional settings), and others requiring flexibility in the intervention to help overcome limited resource availability (Aspirational and Non-Professionalised Community-Based settings).ConclusionsThe CFIR is useful in highlighting the multiple facets at play in creating the optimal pre-implementation context, and where flex is required to achieve this. The CFIR illuminates the similarities and differences between and across settings, highlighting the complexity of open system settings and the important need for pre-implementation work.Trial registrationISRCTN19193075