Integrated knowledge translation in five sub-Saharan African countries: TIDieR checklist description of a complex intervention

Article type
Authors
Sell K1, Jessani N2, Mesfin F3, Rehfuess E1, Rohwer A4, Delobelle P5, Balugaba B6, Schmidt B7, Kedir K3, Mpando T8, Niyibizi J9, Osuret J6, Bayiga-Zziwa E6, Mbeye N8, Pfadenhauer L1
1Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
2Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Institute of Development Studies, United Kingdom
3Non-Communicable Diseases Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
4Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
5Chronic Diseases Initiative for Africa, University of Cape Town, Cape Town, South Africa; Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
6Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
7School of Public Health, University of the Western Cape, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
8School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
9College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
Abstract
"Background: The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) is a consortium of nine academic institutions in Ethiopia, Malawi, Rwanda, South Africa, Uganda and Germany, focused on research on non-communicable diseases and road traffic injuries. The consortium developed, implemented, and evaluated an integrated knowledge translation (IKT) approach, to facilitate continuous engagement with decision-makers in policy and practice in order to enhance evidence-informed decision-making.

Objective: To describe the CEBHA + IKT approach using a template for intervention description and replication (TIDieR checklist) and to reflect on our experience using this checklist.

Methods: We drew on our published protocol (https://rdcu.be/dyIN2), interim findings of the IKT evaluation study (2020-2021), IKT-related documents, a reflective survey and discussions among IKT implementers. Qualitative data were analysed using content analysis and quantitative data were analysed descriptively.

Results: We included preliminary IKT evaluation data (33 interviews, 31 survey responses, 49 documents), and eight responses to the reflective survey. Using TIDieR, the IKT implementation team disentangled the multiple components of this multi-level, multi-site intervention. These components included IKT training for CEBHA+ researchers and the development and implementation of IKT strategies in each of the five African CEBHA + countries, which we considered as ‘multi-pronged ensemble of tailored interventions.’ These site-specific IKT strategies were tailored to the local context, engagement and research aims, and stakeholders. They included a variety of IKT activities which we were not able to report in detail using TIDieR. Due to project-related constraints, the monitoring approach had to be modified, reducing our ability to report on the ‘how well’ checklist item. The full intervention description has been published (https://rdcu.be/dyIOV).

Conclusion: The description of the CEBHA+ IKT approach using TIDieR addressed the lack of published intervention descriptions in this field and delineated implementation realities. It also served as a point of reflection for the CEBHA+ IKT team and supplemented the IKT evaluation study (forthcoming). Critically, whilst the TIDieR checklist provided a useful framework for a structured intervention description, we felt ambiguous about its suitability for reporting on such a complex, multi-layered intervention.
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