Understanding the value of adhering to or adapting evidence-based interventions : a study protocol of a discrete choice experiment

• Background: Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinicaloutcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such asappropriateness, equity, costs, and impact. Reconciling these value conflicts involves a complicated decision processthat has received very limited scholarly attention. Inspired by studies on decision-making, the objective of thisproject is to explore how practitioners appraise the values of different outcomes and to test how this appraisalinfluences their decisions surrounding the so-called fidelity–adaptation dilemma. This dilemma is related to thebalance between using an EBI as it was designed (to ensure its effectiveness) and making appropriate adaptations(to ensure alignment with constraints and possibilities in the local context).Methods: This project consists of three sub-studies. The participants will be professionals leading evidence-basedparental programs in Sweden and, in Sub-study 1, parents and decision-makers. Sub-study 1 will use sequentialfocus groups and individual interviews to explore parameters that influence fidelity and adaptation decisions—thedilemmas encountered, available options, how outcomes are valued by practitioners as well as other stakeholders,and value trade-offs. Sub-study 2 is a discrete choice experiment that will test how value appraisals influencedecision-making using data from Sub-study 1 as input. Sub-study 3 uses a mixed-method design, with findingsfrom the two preceding sub-studies as input in focus group interviews to investigate how practitioners make senseof findings from optimal decision situations (experiment) and constrained, real-world decision situations.Discussion: The project will offer unique insights into decision-making processes that influence how EBIs are usedin practice. Such knowledge is needed for a more granular understanding of how practitioners manage thefidelity–adaptation dilemma and thus, ultimately, how the value of EBI implementation can be optimized. Thisstudy contributes to our knowledge of what happens once EBIs are adopted—that is, the gap between the way inwhich EBIs are intended to be used and the way in which they are used in practice.

Ämnesord

SAMHÄLLSVETENSKAP  -- Psykologi -- Psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology -- Psychology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Tvärvetenskapliga studier inom samhällsvetenskap (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Social Sciences Interdisciplinary (hsv//eng)

Nyckelord

Professionals

Adaptation

Adherence

Fidelity–adaptation dilemma

Evidence-based interventions

Decision-making

Parental support

Discrete choice experiment

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