Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care
Abstract Background Despite evidence supporting interventions that improve outcomes for patients with stroke, their implementation remains suboptimal. Facilitation can support implementation of research into clinical practice by helping people develop the strategies to implement change. However, var...
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| Language: | English |
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BMC
2025-01-01
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| Series: | Implementation Science |
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| Online Access: | https://doi.org/10.1186/s13012-025-01415-w |
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| author | Oyebola Fasugba Heilok Cheng Simeon Dale Kelly Coughlan Elizabeth McInnes Dominique A. Cadilhac Ngai W. Cheung Kelvin Hill Kirsty Page Estela Sanjuan Menendez Emily Neal Vivien Pollnow Julia Slark Eileen Gilder Anna Ranta Christopher Levi Jeremy M. Grimshaw Sandy Middleton |
| author_facet | Oyebola Fasugba Heilok Cheng Simeon Dale Kelly Coughlan Elizabeth McInnes Dominique A. Cadilhac Ngai W. Cheung Kelvin Hill Kirsty Page Estela Sanjuan Menendez Emily Neal Vivien Pollnow Julia Slark Eileen Gilder Anna Ranta Christopher Levi Jeremy M. Grimshaw Sandy Middleton |
| author_sort | Oyebola Fasugba |
| collection | DOAJ |
| description | Abstract Background Despite evidence supporting interventions that improve outcomes for patients with stroke, their implementation remains suboptimal. Facilitation can support implementation of research into clinical practice by helping people develop the strategies to implement change. However, variability in the amount (dose) and type of facilitation activities/facilitator roles that make up the facilitation strategies (content), may affect the effectiveness of facilitation. This review aimed to determine if, and how, facilitation dose is measured or reported and the type of facilitation strategies used to support adoption of stroke interventions in hospitals and subacute settings. We also assessed whether the included studies had reporting checklists or guidelines. Methods The scoping review was based on Arksey and O’Malley’s framework. Cochrane, CINAHL and MEDLINE databases were searched to identify randomised trials and quasi-experimental studies of stroke interventions published between January 2017 and July 2023. Accompanying publications (quantitative, qualitative, mixed methods or process evaluation papers) from eligible studies were also included. Narrative data synthesis was undertaken. Results Ten studies (23 papers) from 649 full-text papers met the inclusion criteria. Only two studies reported the total facilitation dose, measured as the frequency and duration of facilitation encounters. Authors of the remaining eight studies reported only the frequency and/or duration of varying facilitation activities but not the total dose. The facilitation activities included remote external facilitator support via ongoing telecommunication (phone calls, emails, teleconferences), continuous engagement from on-site internal facilitators, face-to-face workshops and/or education sessions from external or internal facilitators. Facilitator roles were broad: site-specific briefing, action planning and/or goal setting; identifying enablers and barriers to change; coaching, training, education or feedback; and network support. Only two studies included reporting checklists/guidelines to support researchers to describe interventions and implementation studies in sufficient detail to enable replication. Conclusions There is a paucity of information on the measurement of facilitation dose and reporting on specific details of facilitation activities in stroke implementation studies. Detailed reporting of dose and content is needed to improve the scientific basis of facilitation as strategic support to enable improvements to stroke care. Development of a standardised measurement approach for facilitation dose would inform future research and translation of findings. |
| format | Article |
| id | doaj-art-048a18968fde4302a3054600879095a0 |
| institution | Kabale University |
| issn | 1748-5908 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science |
| spelling | doaj-art-048a18968fde4302a3054600879095a02025-01-19T12:33:39ZengBMCImplementation Science1748-59082025-01-0120112310.1186/s13012-025-01415-wFinding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke careOyebola Fasugba0Heilok Cheng1Simeon Dale2Kelly Coughlan3Elizabeth McInnes4Dominique A. Cadilhac5Ngai W. Cheung6Kelvin Hill7Kirsty Page8Estela Sanjuan Menendez9Emily Neal10Vivien Pollnow11Julia Slark12Eileen Gilder13Anna Ranta14Christopher Levi15Jeremy M. Grimshaw16Sandy Middleton17Nursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne & Australian Catholic UniversityNursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne & Australian Catholic UniversityNursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne & Australian Catholic UniversityNursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne & Australian Catholic UniversityNursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne & Australian Catholic UniversityStroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash UniversityCentre for Diabetes and Endocrinology Research, Westmead Hospital and University of SydneyStroke Foundation Vincent’s Health Network SydneyVall d’Hebron Hospital Universitari BarcelonaPrince of Wales Hospital Vincent’s Health Network SydneySchool of Nursing, Faculty of Medical and Health Sciences, The University of AucklandSchool of Nursing, Faculty of Medical and Health Sciences, The University of AucklandDepartment of Medicine, University of Otago WellingtonJohn Hunter HospitalDepartment of Medicine, University of OttawaNursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne & Australian Catholic UniversityAbstract Background Despite evidence supporting interventions that improve outcomes for patients with stroke, their implementation remains suboptimal. Facilitation can support implementation of research into clinical practice by helping people develop the strategies to implement change. However, variability in the amount (dose) and type of facilitation activities/facilitator roles that make up the facilitation strategies (content), may affect the effectiveness of facilitation. This review aimed to determine if, and how, facilitation dose is measured or reported and the type of facilitation strategies used to support adoption of stroke interventions in hospitals and subacute settings. We also assessed whether the included studies had reporting checklists or guidelines. Methods The scoping review was based on Arksey and O’Malley’s framework. Cochrane, CINAHL and MEDLINE databases were searched to identify randomised trials and quasi-experimental studies of stroke interventions published between January 2017 and July 2023. Accompanying publications (quantitative, qualitative, mixed methods or process evaluation papers) from eligible studies were also included. Narrative data synthesis was undertaken. Results Ten studies (23 papers) from 649 full-text papers met the inclusion criteria. Only two studies reported the total facilitation dose, measured as the frequency and duration of facilitation encounters. Authors of the remaining eight studies reported only the frequency and/or duration of varying facilitation activities but not the total dose. The facilitation activities included remote external facilitator support via ongoing telecommunication (phone calls, emails, teleconferences), continuous engagement from on-site internal facilitators, face-to-face workshops and/or education sessions from external or internal facilitators. Facilitator roles were broad: site-specific briefing, action planning and/or goal setting; identifying enablers and barriers to change; coaching, training, education or feedback; and network support. Only two studies included reporting checklists/guidelines to support researchers to describe interventions and implementation studies in sufficient detail to enable replication. Conclusions There is a paucity of information on the measurement of facilitation dose and reporting on specific details of facilitation activities in stroke implementation studies. Detailed reporting of dose and content is needed to improve the scientific basis of facilitation as strategic support to enable improvements to stroke care. Development of a standardised measurement approach for facilitation dose would inform future research and translation of findings.https://doi.org/10.1186/s13012-025-01415-wFacilitationImplementation StrategyDoseIntensityContentScoping Review |
| spellingShingle | Oyebola Fasugba Heilok Cheng Simeon Dale Kelly Coughlan Elizabeth McInnes Dominique A. Cadilhac Ngai W. Cheung Kelvin Hill Kirsty Page Estela Sanjuan Menendez Emily Neal Vivien Pollnow Julia Slark Eileen Gilder Anna Ranta Christopher Levi Jeremy M. Grimshaw Sandy Middleton Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care Implementation Science Facilitation Implementation Strategy Dose Intensity Content Scoping Review |
| title | Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care |
| title_full | Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care |
| title_fullStr | Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care |
| title_full_unstemmed | Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care |
| title_short | Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care |
| title_sort | finding the right dose a scoping review examining facilitation as an implementation strategy for evidence based stroke care |
| topic | Facilitation Implementation Strategy Dose Intensity Content Scoping Review |
| url | https://doi.org/10.1186/s13012-025-01415-w |
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