A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey
Abstract Background In many Asian jurisdictions, patients are required to obtain referrals from registered doctors before consulting physiotherapists. In contrast, countries such as the United States, the United Kingdom, and Australia have a direct access model for physiotherapists designed across d...
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| Format: | Article |
| Language: | English |
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BMC
2024-12-01
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| Series: | Implementation Science Communications |
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| Online Access: | https://doi.org/10.1186/s43058-024-00680-y |
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| author | Eng Kiong Yeoh Carrie Ho Kwan Yam Ethan Ming Yin Ip Tsz Yu Chow Chi Tim Hung |
| author_facet | Eng Kiong Yeoh Carrie Ho Kwan Yam Ethan Ming Yin Ip Tsz Yu Chow Chi Tim Hung |
| author_sort | Eng Kiong Yeoh |
| collection | DOAJ |
| description | Abstract Background In many Asian jurisdictions, patients are required to obtain referrals from registered doctors before consulting physiotherapists. In contrast, countries such as the United States, the United Kingdom, and Australia have a direct access model for physiotherapists designed across different healthcare settings and under prescribed conditions. While research has demonstrated the benefits of direct access, issues remain on the appropriate policy design for direct access in the context of patient safety and organizational challenges in the implementation. Recently the policy to allow direct access in primary care context is being considered in Hong Kong. This study aims to examine the intervention design options for the policy of direct access to physiotherapists and identify corresponding implementation strategies, to inform the appropriate intervention design for direct access to physiotherapists and the implementation strategies. Methods We adopt a systematic process for developing the design of the policy and the implementation strategies using an Implementation Mapping approach informed by Consolidated Framework for Implementation Research (CFIR). We will conduct literature reviews to understand the different aspects of policy intervention design and employ qualitative in-depth interviews and focus group discussions to understand key stakeholders’ perspectives related to the direct access model. The identified barriers and facilitators associated with policy implementation of an acceptable intervention design will inform the development of an effective implementation strategy tailored to the implementation context. Our approach will involve mapping the research evidence and the subsequent findings from the stakeholders’ deliberations into the CFIR domains and referencing the Expert Recommendations for Implementing Change (ERIC) to develop the acceptable intervention characteristics and the corresponding implementation strategies. These insights will be further validated in a Delphi Expert Survey, for a consensus-based approach. Discussion This study employs a sequential mixed-method approach to explore the intervention characteristics for an acceptable intervention design in the policy formulation and the corresponding implementation strategy for direct access to physiotherapists. Integrating research insights into actionable policy recommendations and refining these recommendations in a Delphi Survey will inform the appropriate policy intervention design and implementation strategy for direct access to physiotherapy services. |
| format | Article |
| id | doaj-art-2f06774db19e4c01b836af6c61a6f7b1 |
| institution | OA Journals |
| issn | 2662-2211 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj-art-2f06774db19e4c01b836af6c61a6f7b12025-08-20T01:59:43ZengBMCImplementation Science Communications2662-22112024-12-015111210.1186/s43058-024-00680-yA study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi surveyEng Kiong Yeoh0Carrie Ho Kwan Yam1Ethan Ming Yin Ip2Tsz Yu Chow3Chi Tim Hung4The Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongThe Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongThe Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongThe Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongThe Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongAbstract Background In many Asian jurisdictions, patients are required to obtain referrals from registered doctors before consulting physiotherapists. In contrast, countries such as the United States, the United Kingdom, and Australia have a direct access model for physiotherapists designed across different healthcare settings and under prescribed conditions. While research has demonstrated the benefits of direct access, issues remain on the appropriate policy design for direct access in the context of patient safety and organizational challenges in the implementation. Recently the policy to allow direct access in primary care context is being considered in Hong Kong. This study aims to examine the intervention design options for the policy of direct access to physiotherapists and identify corresponding implementation strategies, to inform the appropriate intervention design for direct access to physiotherapists and the implementation strategies. Methods We adopt a systematic process for developing the design of the policy and the implementation strategies using an Implementation Mapping approach informed by Consolidated Framework for Implementation Research (CFIR). We will conduct literature reviews to understand the different aspects of policy intervention design and employ qualitative in-depth interviews and focus group discussions to understand key stakeholders’ perspectives related to the direct access model. The identified barriers and facilitators associated with policy implementation of an acceptable intervention design will inform the development of an effective implementation strategy tailored to the implementation context. Our approach will involve mapping the research evidence and the subsequent findings from the stakeholders’ deliberations into the CFIR domains and referencing the Expert Recommendations for Implementing Change (ERIC) to develop the acceptable intervention characteristics and the corresponding implementation strategies. These insights will be further validated in a Delphi Expert Survey, for a consensus-based approach. Discussion This study employs a sequential mixed-method approach to explore the intervention characteristics for an acceptable intervention design in the policy formulation and the corresponding implementation strategy for direct access to physiotherapists. Integrating research insights into actionable policy recommendations and refining these recommendations in a Delphi Survey will inform the appropriate policy intervention design and implementation strategy for direct access to physiotherapy services.https://doi.org/10.1186/s43058-024-00680-yDirect physiotherapist accessImplementation mappingImplementation research logic modelIntervention characteristicsPolicy designDeterminants |
| spellingShingle | Eng Kiong Yeoh Carrie Ho Kwan Yam Ethan Ming Yin Ip Tsz Yu Chow Chi Tim Hung A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey Implementation Science Communications Direct physiotherapist access Implementation mapping Implementation research logic model Intervention characteristics Policy design Determinants |
| title | A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey |
| title_full | A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey |
| title_fullStr | A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey |
| title_full_unstemmed | A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey |
| title_short | A study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care: a sequential mixed-method study using implementation mapping and a Delphi survey |
| title_sort | study protocol for the policy intervention design and development of the implementation strategies for direct access to physiotherapists in primary care a sequential mixed method study using implementation mapping and a delphi survey |
| topic | Direct physiotherapist access Implementation mapping Implementation research logic model Intervention characteristics Policy design Determinants |
| url | https://doi.org/10.1186/s43058-024-00680-y |
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