Exploring the potential roles of community-university partnerships in northern suicide prevention implementation research

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ABSTRACT

This paper discusses the lessons learned from a partnership project on suicide prevention carried out with Inuit organisations in Nunavut and Nunavik. The aim was to identify research needs, processes, and opportunities for knowledge translation to guide suicide prevention activities. Key reflections among partners regarding regional needs and the potential roles of research in suicide prevention in northern Canada are described as well as the three identified priorities: (1) focusing on community mobilisation; (2) supporting access to scientific information; and (3) supporting the adaptation of evaluation criteria and protocols of ongoing community activities. Strategies to address these priorities are presented.

RÉSUMÉ

Cet article présente les leçons tirées d’un projet de recherche en prévention du suicide, mené en partenariat avec des organisations du Nunavut et du Nunavik. L’objectif était d’identifier les besoins de recherche, les processus et les possibilités d’application des connaissances afin d’orienter les activités de prévention du suicide dans ces régions. Les réflexions principales des partenaires quant aux besoins régionaux et aux rôles de la recherche sont ici décrites. Trois priorités ont été identifiées: 1) la mobilisation des communautés; 2) l’accès à l’information; et 3) l’évaluation des activités en cours. Les stratégies imaginées pour répondre à ces priorités sont présentées.

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Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Laura Damschroder, David Aron, Rosalind E Keith … (2009)

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.

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Implementation research: new imperatives and opportunities in global health

Sally Theobald, Neal Brandes, Margaret Gyapong … (2018)

Implementation research is important in global health because it addresses the challenges of the know-do gap in real-world settings and the practicalities of achieving national and global health goals. Implementation research is an integrated concept that links research and practice to accelerate the development and delivery of public health approaches. Implementation research involves the creation and application of knowledge to improve the implementation of health policies, programmes, and practices. This type of research uses multiple disciplines and methods and emphasises partnerships between community members, implementers, researchers, and policy makers. Implementation research focuses on practical approaches to improve implementation and to enhance equity, efficiency, scale-up, and sustainability, and ultimately to improve people's health. There is growing interest in the principles of implementation research and a range of perspectives on its purposes and appropriate methods. However, limited efforts have been made to systematically document and review learning from the practice of implementation research across different countries and technical areas. Drawing on an expert review process, this Health Policy paper presents purposively selected case studies to illustrate the essential characteristics of implementation research and its application in low-income and middle-income countries. The case studies are organised into four categories related to the purposes of using implementation research, including improving people's health, informing policy design and implementation, strengthening health service delivery, and empowering communities and beneficiaries. Each of the case studies addresses implementation problems, involves partnerships to co-create solutions, uses tacit knowledge and research, and is based on a shared commitment towards improving health outcomes. The case studies reveal the complex adaptive nature of health systems, emphasise the importance of understanding context, and highlight the role of multidisciplinary, rigorous, and adaptive processes that allow for course correction to ensure interventions have an impact. This Health Policy paper is part of a call to action to increase the use of implementation research in global health, build the field of implementation research inclusive of research utilisation efforts, and accelerate efforts to bridge the gap between research, policy, and practice to improve health outcomes.

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Evolution of Wenger's concept of community of practice

Linda C. Li, Jeremy M. Grimshaw, Camilla Nielsen … (2009)

Background In the experience of health professionals, it appears that interacting with peers in the workplace fosters learning and information sharing. Informal groups and networks present good opportunities for information exchange. Communities of practice (CoPs), which have been described by Wenger and others as a type of informal learning organization, have received increasing attention in the health care sector; however, the lack of uniform operating definitions of CoPs has resulted in considerable variation in the structure and function of these groups, making it difficult to evaluate their effectiveness. Objective To critique the evolution of the CoP concept as based on the germinal work by Wenger and colleagues published between 1991 and 2002. Discussion CoP was originally developed to provide a template for examining the learning that happens among practitioners in a social environment, but over the years there have been important divergences in the focus of the concept. Lave and Wenger's earliest publication (1991) centred on the interactions between novices and experts, and the process by which newcomers create a professional identity. In the 1998 book, the focus had shifted to personal growth and the trajectory of individuals' participation within a group (i.e., peripheral versus core participation). The focus then changed again in 2002 when CoP was applied as a managerial tool for improving an organization's competitiveness. Summary The different interpretations of CoP make it challenging to apply the concept or to take full advantage of the benefits that CoP groups may offer. The tension between satisfying individuals' needs for personal growth and empowerment versus an organization's bottom line is perhaps the most contentious of the issues that make CoPs difficult to cultivate. Since CoP is still an evolving concept, we recommend focusing on optimizing specific characteristics of the concept, such as support for members interacting with each other, sharing knowledge, and building a sense of belonging within networks/teams/groups. Interventions that facilitate relationship building among members and that promote knowledge exchange may be useful for optimizing the function of these groups.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Circumpolar Health

Journal ID (iso-abbrev): Int J Circumpolar Health

Title: International Journal of Circumpolar Health

Publisher: Taylor & Francis

ISSN (Print): 1239-9736

ISSN (Electronic): 2242-3982

Publication date (Electronic, pub): 11 November 2020

Publication date (Electronic, collection): 2020

Volume: 79

Issue: 1

Electronic Location Identifier: 1835271

Affiliations

[a ]School of Psychoeducation, Pitutsimajut Partnership Research, University of Montréal; , Montréal, Québec, Canada

[b ]Department of Psychology, Université du Québec à Montréal; , Montréal, Québec, Canada

[c ]Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University; , Montreal, Québec, Canada

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CONTACT Sarah Fraser sarah.fraser.1@ 123456umontreal.ca Pavillon Marie-Victorin, Pitutsimajut Research Lab, University of Montréal; , Montréal, QuébecH3C 3J7, Canada

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Laurence J. Kirmayer https://orcid.org/0000-0002-6228-1739

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Publisher ID: 1835271

DOI: 10.1080/22423982.2020.1835271

PMC ID: 7671706

PubMed ID: 33175672

SO-VID: 72b6f94d-ab5c-4308-999c-473544a92380

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Exploring the potential roles of community-university partnerships in northern suicide prevention implementation research

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Most cited references 32

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Implementation research: new imperatives and opportunities in global health

Evolution of Wenger's concept of community of practice

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