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Implementation salvage experiences from the Melbourne diabetes prevention study

Dunbar, James, Hernan, Andrea, Janus, Edward, Davis-Lameloise, Nathalie, Asproloupos, Dino, O'Reilly, Sharleen, Timoshanko, Amy, Stewart, Elizabeth, Bennett, Catherine M., Johnson, Greg and Carter, Rob 2012, Implementation salvage experiences from the Melbourne diabetes prevention study, BMC public health, vol. 12, no. 806, pp. 1-9, doi: 10.1186/1471-2458-12-806.

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Title Implementation salvage experiences from the Melbourne diabetes prevention study
Author(s) Dunbar, JamesORCID iD for Dunbar, James orcid.org/0000-0003-0866-4365
Hernan, AndreaORCID iD for Hernan, Andrea orcid.org/0000-0003-4542-1186
Janus, Edward
Davis-Lameloise, Nathalie
Asproloupos, Dino
O'Reilly, SharleenORCID iD for O'Reilly, Sharleen orcid.org/0000-0003-3547-6634
Timoshanko, Amy
Stewart, Elizabeth
Bennett, Catherine M.ORCID iD for Bennett, Catherine M. orcid.org/0000-0001-9581-1612
Johnson, Greg
Carter, RobORCID iD for Carter, Rob orcid.org/0000-0002-1586-5619
Journal name BMC public health
Volume number 12
Issue number 806
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, England
Publication date 2012-09-19
ISSN 1471-2458
Keyword(s) implementation
salvage strategy
type 2 diabetes
prevention
effectiveness
randomised controlled trial
Summary Background Many public health interventions based on apparently sound evidence from randomised controlled trials encounter difficulties when being scaled up within health systems. Even under the best of circumstances, implementation is exceedingly difficult. In this paper we will describe the implementation salvage experiences from the Melbourne Diabetes Prevention Study, which is a randomised controlled trial of the effectiveness and cost-effectiveness nested in the state-wide Life! Taking Action on Diabetes program in Victoria, Australia.

Discussion The Melbourne Diabetes Prevention Study sits within an evolving larger scale implementation project, the Life! program. Changes that occurred during the roll-out of that program had a direct impact on the process of conducting this trial. The issues and methods of recovery the study team encountered were conceptualised using an implementation salvage strategies framework. The specific issues the study team came across included continuity of the state funding for Life! program and structural changes to the Life! program which consisted of adjustments to eligibility criteria, referral processes, structure and content, as well as alternative program delivery for different population groups. Staff turnover, recruitment problems, setting and venue concerns, availability of potential participants and participant characteristics were also identified as evaluation roadblocks. Each issue and corresponding salvage strategy is presented.

Summary The experiences of conducting such a novel trial as the preliminary Melbourne Diabetes Prevention Study have been invaluable. The lessons learnt and knowledge gained will inform the future execution of this trial in the coming years. We anticipate that these results will also be beneficial to other researchers conducting similar trials in the public health field. We recommend that researchers openly share their experiences, barriers and challenges when conducting randomised controlled trials and implementation research. We encourage them to describe the factors that may have inhibited or enhanced the desired outcomes so that the academic community can learn and expand the research foundation of implementation salvage.
Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Language eng
DOI 10.1186/1471-2458-12-806
Field of Research 140208 Health Economics
Socio Economic Objective 920204 Evaluation of Health Outcomes
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, Dunbar et al.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30052465

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.