TY - JOUR
T1 - Unravelling complex primary-care programs to maintain independent living in older people: 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 - Van Charante, Eric P. Moll
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
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. (C) 2018 The Authors. Published by Elsevier Inc.
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. (C) 2018 The Authors. Published by Elsevier Inc.
KW - Complex interventions
KW - Primary-care programs
KW - Improvement
KW - Development
KW - Evaluation
KW - Systematic overview
KW - RANDOMIZED CONTROLLED-TRIAL
KW - HEALTH-SERVICES RESEARCH
KW - INTEGRATED CARE
KW - BEHAVIOR-CHANGE
KW - IMPROVE HEALTH
KW - TREATMENT FIDELITY
KW - CONSORT EXTENSION
KW - GENERAL-PRACTICE
KW - INTERVENTIONS
KW - FRAIL
U2 - 10.1016/j.jclinepi.2017.12.013
DO - 10.1016/j.jclinepi.2017.12.013
M3 - Article
C2 - 29289764
SN - 0895-4356
VL - 96
SP - 110
EP - 119
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -