Moving knowledge into practice: Evaluating cross-cultural applicability of the Promoting Action on Research Implementation in Health Service framework
Aims
To explore the appropriateness and utility of the Promoting Action on Research Implementation in Health Service (PARIHS) framework in the cultural translation and adaptation of an evidence-based clinical practice guideline into clinical practice in the healthcare system in Malta. To identify the challenges and barriers to successful cultural translation and implementation to inform future cross-cultural knowledge translation programmes.
Methods
This was an embedded single case, case study. Data collection was facilitated using focus groups with multidisciplinary healthcare professionals, semi-structured interviews, non-participant observation of two guideline development groups. Data were analysed both inductively and deductively using Framework Analysis. Guideline development was based on NICE methodology.
Results
Findings indicate that the components of the PARIHS framework of evidence, context and facilitation are useful to guide the cultural translation and adaptation of an evidence-based clinical practice guideline. Challenges and barriers to successful translation and potential implementation were identified; the influence of politics, culture and context, resources; human and financial and stakeholder involvement.
Conclusion
The PARIHS framework can be used to guide the cultural translation and adaptation of an evidence-based clinical practice guideline in a cross-cultural setting. For the PARIHS framework to be fully applicable it is suggested that a number of adaptations are made, primarily:
the definition of context needs to be expanded to include the wider social / political / organisational context
culture needs to be a standalone sub element of context to understand the multifaceted role it has
the role of the patient and the influence they can have needs to be included
politics should be included as a sub element of context
the influential role of resources, both human and financial needs to be better recognised.
Conflict of interest statement
There are no conflicts of interest.
- © Royal College of Physicians 2019. All rights reserved.
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