TY - JOUR
T1 - Unravelling complex primary-care programs to maintain independent living in older people
T2 - a systematic overview
AU - Smit, Linda C.
AU - Schuurmans, Marieke J.
AU - Blom, Jeanet W.
AU - Fabbricotti, Isabelle N.
AU - Jansen, Aaltje P.D.
AU - Kempen, Gertrudis I.J.M.
AU - Koopmans, Raymond
AU - Looman, Willemijn M.
AU - Melis, Rene J.F.
AU - Metzelthin, Silke F.
AU - Moll van Charante, Eric P.
AU - Muntinga, Maaike E.
AU - Ruikes, Franca G.H.
AU - Spoorenberg, Sophie L.W.
AU - Suijker, Jacqueline J.
AU - Wynia, Klaske
AU - Gussekloo, Jacobijn
AU - De Wit, Niek J.
AU - Bleijenberg, Nienke
N1 - Funding Information:
Funding: This study was funded by the Netherlands Organization for Health Research and Development (ZonMw), grant number 63300095103, within the NCEP. The funders had no role in the study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.
Publisher Copyright:
© 2018 The Authors
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Objectives: Complex interventions are criticized for being a “black box”, which makes it difficult to determine why they succeed or fail. Recently, nine proactive primary-care programs aiming to prevent functional decline in older adults showed inconclusive effects. The aim of this study was to systematically unravel, compare, and synthesize the development and evaluation of nine primary-care programs within a controlled trial to further improve the development and evaluation of complex interventions. Study Design and Setting: A systematic overview of all written data on the nine proactive primary-care programs was conducted using a validated item list. The nine proactive primary-care programs involved 214 general practices throughout the Netherlands. Results: There was little or no focus on the (1) context surrounding the care program, (2) modeling of processes and outcomes, (3) intervention fidelity and adaptation, and (4) content and evaluation of training for interventionists. Conclusions: An in-depth analysis of the context, modeling of the processes and outcomes, measurement and reporting of intervention fidelity, and implementation of effective training for interventionists is needed to enhance the development and replication of future complex interventions.
AB - Objectives: Complex interventions are criticized for being a “black box”, which makes it difficult to determine why they succeed or fail. Recently, nine proactive primary-care programs aiming to prevent functional decline in older adults showed inconclusive effects. The aim of this study was to systematically unravel, compare, and synthesize the development and evaluation of nine primary-care programs within a controlled trial to further improve the development and evaluation of complex interventions. Study Design and Setting: A systematic overview of all written data on the nine proactive primary-care programs was conducted using a validated item list. The nine proactive primary-care programs involved 214 general practices throughout the Netherlands. Results: There was little or no focus on the (1) context surrounding the care program, (2) modeling of processes and outcomes, (3) intervention fidelity and adaptation, and (4) content and evaluation of training for interventionists. Conclusions: An in-depth analysis of the context, modeling of the processes and outcomes, measurement and reporting of intervention fidelity, and implementation of effective training for interventionists is needed to enhance the development and replication of future complex interventions.
KW - Complex interventions
KW - Development
KW - Evaluation
KW - Improvement
KW - Primary-care programs
KW - Systematic overview
UR - https://www.scopus.com/pages/publications/85040535261
U2 - 10.1016/j.jclinepi.2017.12.013
DO - 10.1016/j.jclinepi.2017.12.013
M3 - Article
AN - SCOPUS:85040535261
SN - 0895-4356
VL - 96
SP - 110
EP - 119
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -