Article type
Abstract
"Background
The GRADE-Adolopment framework was developed to address the growing need for a systematic and transparent method to adapt guidelines to the local setting. Few studies assessed its implementation in low- to middle-income countries like the Philippines. This study aimed to evaluate the implementation of the development of Philippine Periodic Health Examination Guidelines using the GRADE Adolopment and determine facilitators and barriers to its implementation in the Philippine setting.
Methodology
We used a mixed-method study using a sequential exploratory design. Qualitative data collection was done through key informant interviews (KII) and confirmed through an online survey and document review. Task force members were interviewed regarding the acceptability, appropriateness, and feasibility of the GRADE Adolopment. They were also asked on the facilitators, barriers and areas for improvement regarding its implementation. Qualitative data were analyzed using content analysis. Quantitative data were integrated with the qualitative data through building and merging.
Results
Document review, 14 KIIs and an online survey (n=109) were conducted between September 2022 to May 2023. GRADE Adolopment was deemed appropriate because it is resource-friendly and comprehensive, allows contextualization, emphasizes values and preferences, and identifies research gaps. It was acceptable because it facilitates collaboration, nurtures learning, builds trust, manages biases, improves efficiency, and exemplifies evidence-based decision-making. It was feasible because it was structured and systematic. Facilitators were access to high-quality evidence, prior skills and experience, and technical guidance and supervision. Barriers were non-familiarity, complexities of screening questions, lack of standardization, lack of evidence, lack of considerations on equity and feasibility, lack of funding, lack of end-user and patient representation and empowerment, and lack of technical skills and knowledge, and manpower. Capacity building, question formulation, multisectoral representation, dissemination and implementation of the guidelines, management of conflict of interest, monitoring and evaluation, quality control, timelines, standardization, and resource allocation were the identified areas for improvement.
Conclusion
The GRADE Adolopment framework is suitable for developing CPGs for Filipinos and can be adopted in the Philippine guideline development process. To ensure successful implementation, stakeholders must be empowered and provided with the necessary resources, training, guidance, and support."
The GRADE-Adolopment framework was developed to address the growing need for a systematic and transparent method to adapt guidelines to the local setting. Few studies assessed its implementation in low- to middle-income countries like the Philippines. This study aimed to evaluate the implementation of the development of Philippine Periodic Health Examination Guidelines using the GRADE Adolopment and determine facilitators and barriers to its implementation in the Philippine setting.
Methodology
We used a mixed-method study using a sequential exploratory design. Qualitative data collection was done through key informant interviews (KII) and confirmed through an online survey and document review. Task force members were interviewed regarding the acceptability, appropriateness, and feasibility of the GRADE Adolopment. They were also asked on the facilitators, barriers and areas for improvement regarding its implementation. Qualitative data were analyzed using content analysis. Quantitative data were integrated with the qualitative data through building and merging.
Results
Document review, 14 KIIs and an online survey (n=109) were conducted between September 2022 to May 2023. GRADE Adolopment was deemed appropriate because it is resource-friendly and comprehensive, allows contextualization, emphasizes values and preferences, and identifies research gaps. It was acceptable because it facilitates collaboration, nurtures learning, builds trust, manages biases, improves efficiency, and exemplifies evidence-based decision-making. It was feasible because it was structured and systematic. Facilitators were access to high-quality evidence, prior skills and experience, and technical guidance and supervision. Barriers were non-familiarity, complexities of screening questions, lack of standardization, lack of evidence, lack of considerations on equity and feasibility, lack of funding, lack of end-user and patient representation and empowerment, and lack of technical skills and knowledge, and manpower. Capacity building, question formulation, multisectoral representation, dissemination and implementation of the guidelines, management of conflict of interest, monitoring and evaluation, quality control, timelines, standardization, and resource allocation were the identified areas for improvement.
Conclusion
The GRADE Adolopment framework is suitable for developing CPGs for Filipinos and can be adopted in the Philippine guideline development process. To ensure successful implementation, stakeholders must be empowered and provided with the necessary resources, training, guidance, and support."