Implementation of a diabetes prevention model

What are the aims of this project?

The study is an evaluation of an existing integrated modelling framework for type 2 diabetes prevention. The purpose of the model was to produce results to inform local commissioners and national policy makers both on effective / cost­effective intervention strategies where evidence is strong enough, and on research gaps and priorities for applied public health research where evidence is limited and resolving uncertainties in the evidence could affect public health substantially. The modelling work was conducted at the School of Health and Related Research within the Public Health Section, at the University of Sheffield.
Current study aims:
1) To investigate in depth the acceptability, utility and likely adoption of an integrated modelling framework for type 2 diabetes prevention.

Why is this important?

The literature shows that only limited research has so far investigated the implementation of economic decision aids into real world public health contexts. Consequently, the proposed study aims to investigate in depth, through a series of interviews and 'observations' of meetings and similar events at Doncaster Council, the utility, adaptability, and likely adoption of the model by key stakeholders. We propose to examining ways of making the model more 'user friendly' so that it can be incorporated into local level decision­making, and explore the usefulness of drawing on relevant implementation and knowledge translation frameworks to identify factors that might facilitate and constrain this process. As part of the evaluation we will consider the 'model/tool' as an 'innovation' and therefore draw on current conceptual and theoretical frameworks on the diffusion of innovations to inform the investigation? One framework, which we will use to inform the evaluation is 'Normalisation Process Theory' that attempts to identify the issues which affect the adoption and implementation of new innovations within organisations.

How will the research be carried out?

The aim of this case study is to explore the acceptability, utility and potential adoption of the integrated modelling framework for type 2 diabetes prevention. We propose to conduct an in depth case study to fulfil the aims and objectives of this study, using the following methods.
Observations: We will organise a series of regular meetings (up to 8) with key stake holders at Doncaster Council to explore acceptability and utility of the simulation model, and to identify the benefits to staff and barriers to adoption at key stages of development. The meetings will be audio recorded with permission, transcribed, and analysed in N­Vivo 10 using a thematic approach broadly based on the 'constant comparative' framework. In addition, the researcher will take field notes focusing on the content of discussions, producing summaries of the areas for further development within the simulation model. Observations will focus on the iterations between Local Authority staff and the study team in describing the evolution of the simulation model as it is perceived and/or used by local authority staff.
Qualitative semi­structured interviews: A series of interviews (up to 20) with key stake holders will be convened at Doncaster Council using snowball sampling, to explore changing views towards the simulation model, expectations of staff, local/national priorities, constraints and experiences of using the model. 'Snowball' sampling refers to the identification of potential participants through existing contacts. This method to recruitment is particularly useful for finding participants with relevant knowledge and experience relating to the study aims and objectives. In the current study, we will ask observation study participants (see above) to identify potential participants who are likely to provide useful perspectives on the simulation model for local commissioning decisions. The final number of interviews will be determined by by a balance between the relevant participants who are willing to be interviewed and the principles of 'data saturation' (the point after which no new themes or insights can be identified from the data). The interviews will be audio recorded and transcribed for analysis in N­Vivo 10. Preliminary analyses will be fed back to participants in line with the principles of knowledge co-production, to engage in a productive two way conversation about the utility and value of the simulation model enabling the research team to identify key challenges as well as benefits of the model throughout the course of the fieldwork and analysis phases. Regular meetings between the study team will be held and recorded (written notes or audio recorded) to glean the study team's perspective of interacting with the LA organisations and the evolution of the simulation model. This will offer insights into the challenges of model development from a research/academic perspective.
Feedback communications will be organised throughout the case study period, and a final feedback workshop conducted at the end of the study. Any other outputs will be shaped by ongoing discussions/interviews/meetings, based on participants' expectations and needs. Eg. these could be simple summaries of how and in what context the simulation model has greatest utility.

Timeframe:

August 2015 to April 2016

Who is undertaking the research?

The research is led by Dr Tom Sanders (ScHARR). The research team also includes Professor Elizabeth Goyder, Professor Sarah Salway, Dr Penny Breeze.

How are stakeholders being engaged?

Rachel Manners (Obesity Services Lead) and Susan Hampshaw (Head of Research) at Doncaster Borough Council are collaborators on the study. Their involvement will link the study into policy decisions and commissioning around obesity and weight management.
The CLAHRC YH Translating Knowledge to Action Theme supports this research and provides expertise from implementation science and knowledge mobilisation to accelerate the adoption of findings into practice.
Web link: http://clahrc­yh.nihr.ac.uk/our­themes/translating­knowledge­into­action/meet­the­team

What will be the outputs from the study?

The findings from this research will be published in peer reviewed journals. Other outputs will include conference presentations. Preliminary findings have recently been presented at the “Excellence and Innovation in Public Health Conference, Sheffield University.