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Girard A, Doucet A, Lambert M, Ouadfel S, Caron G, Hudon C. What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review. BMJ Open 2024; 14:e084883. [PMID: 38951001 PMCID: PMC11328637 DOI: 10.1136/bmjopen-2024-084883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVE To synthesise current knowledge about the role of external facilitators as an individual role during the implementation of complex interventions in healthcare settings. DESIGN A scoping review was conducted. We reviewed original studies (between 2000 and 2023) about implementing an evidence-based complex intervention in a healthcare setting using external facilitators to support the implementation process. An information specialist used the following databases for the search strategy: MEDLINE, CINAHL, APA PsycINFO, Academic Search Complete, EMBASE (Scopus), Business Source Complete and SocINDEX. RESULTS 36 reports were included for analysis, including 34 different complex interventions. We performed a mixed thematic analysis to synthesise the data. We identified two primary external facilitator roles: lead facilitator and process expert facilitator. Process expert external facilitators have specific responsibilities according to their role and expertise in supporting three main processes: clinical, change management and knowledge/research management. CONCLUSIONS Future research should study processes supported by external facilitators and their relationship with facilitation strategies and implementation outcomes. Future systematic or realist reviews may also focus on outcomes and the effectiveness of external facilitation.
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Affiliation(s)
- Ariane Girard
- School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Amélie Doucet
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Mireille Lambert
- Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sarah Ouadfel
- Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Genève Caron
- Departement of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine Hudon
- Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Salsi S, Ariano E, Casey J, Loewen M, Engel L. Financial Capability Interventions Used for Specific Diagnoses Related to Functional Impairment: A Scoping Review. Am J Occup Ther 2024; 78:7801205060. [PMID: 38305720 DOI: 10.5014/ajot.2024.050254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
IMPORTANCE Occupational therapists often address financial occupations of clients with acquired functional impairments who experience challenges with financial capability (FC). OBJECTIVE To explore the intervention literature aimed at improving FC in five diagnostic adult populations. DATA SOURCES MEDLINE, CINAHL, PsycInfo, EconLit, and EMBASE; researchers also completed backward and forward citation searching and contacted expert authors. STUDY SELECTION AND DATA COLLECTION Two independent reviewers completed article screening, selection, and extraction using a scoping review approach; a priori inclusion criteria were peer-reviewed articles, written in English, involving adults with one of five diagnostic conditions, describing any intervention to improve FC. FINDINGS Twenty-four articles met the inclusion criteria. Most articles were aimed at substance use or mental health populations (n = 20); fewer focused on brain injury (n = 2), multiple sclerosis (n = 1), or mixed-diagnosis (n = 1) populations. Only 4 were randomized controlled trials (RCTs). Interventions were heterogeneous and complex, including components of skills training (n = 21), individualized budgeting (n = 18), representative payeeship (n = 11), education (n = 10), structured goal setting (n = 7), savings building (n = 5), metacognitive strategies (n = 2), and assistive technology (n = 1). CONCLUSIONS AND RELEVANCE Despite growth in the area, the literature regarding FC intervention is limited, with few RCTs and many populations unrepresented. The literature for a systematic review of FC intervention efficacy for these populations is insufficient, particularly because included studies used varied components, limiting comparison. Further research is imperative to guide evidence-based practice. Plain-Language Summary: This study is an overview of literature about interventions to address the financial occupations of clients with acquired functional impairments. The findings give occupational therapy researchers and clinicians the information they need to begin analyzing, using, and building the evidence to support the use of interventions to improve clients' financial capability and well-being.
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Affiliation(s)
- Sofia Salsi
- Sofia Salsi, MScA OT, OT Reg (MB), is PhD Graduate Student, Applied Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Emily Ariano
- Emily Ariano, MOT, OT Reg (MB), is Occupational Therapist, Victoria General Hospital, Winnipeg, Manitoba, Canada. At the time of this review, Ariano was Master of Occupational Therapy Student, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jennifer Casey
- Jennifer Casey, MOT, OT Reg (Ont.), is Occupational Therapist, Children's Therapy Collective and Children's First Initiative, Winnipeg, Manitoba, and Fort Frances, Ontario, Canada. At the time of this review, Casey was Master of Occupational Therapy Student, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Morgan Loewen
- Morgan Loewen, MOT, OT Reg (MB), is Occupational Therapist, Deer Lodge Centre, Winnipeg, Manitoba, Canada. At the time of this review, Loewen was Master of Occupational Therapy Student, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa Engel
- Lisa Engel, MSc (OT), PhD, OT Reg (MB), is Assistant Professor, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, and Institute for Work and Health, Toronto, Ontario, Canada;
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