An analysis of the adaptability of a professional development program in public health: results from the ALPS Study

Abstract

BackgroundProfessional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners’ complex real-world practice settings while preserving the core components of those programs’ models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site.MethodsThis paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization.ResultsWhile each team developed a unique pattern of implementing the activities, all the program’s core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process.ConclusionsThis paper shows how a professional development program model can be adapted to different contexts while preserving its core components. Capturing the heterogeneity of the intervention’s exposure, as was done here, will make possible in-depth impact analyses involving, for example, the testing of program–context interactions to identify program outcomes predictors. Such work is essential to advance knowledge on the action mechanisms of professional development programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0903-3) contains supplementary material, which is available to authorized users.

Organizational Knowledge Creation in the Context of a Professional Development Program: Mixed-Methods Longitudinal Results From the ALPS Study

“…[so] it definitely meant the others [non-participants] from the regular team had to take on more work.” Respondents also reported that the lack of resources constituted an obstacle to knowledge dissemination: “To disseminate [laboratory information]? I think it’s the time, we’re running out of time to do this.” Lab C was in a university-affiliated organization characterized by high importance attached to continuing education (Richard et al, 2015), including in public health, which may have contributed positively to knowledge dissemination. The existence of numerous vehicles to disseminate information, which is typical of a university setting (e.g., regular team meetings, lunch-time conferences), was reported as a facilitative factor.…”

“…This article reports the results of an explanatory case study of two laboratories; the aim was to describe the creation of knowledge through these laboratories and its dissemination in the organization, as well as to identify the factors that facilitated such a process. This article adds to previously published contributions that have reported results regarding other dimensions of the laboratory evaluation: implementation, intervention logic, and effects on professionals (Richard et al, 2015;Tremblay, Brousselle, Richard, & Beaudet, 2013;Tremblay, Richard, Brousselle, & Beaudet, 2014).…”

“…I think it's the time, we're running out of time to do this." Lab C was in a university-affiliated organization characterized by high importance attached to continuing education (Richard et al, 2015), including in public health, which may have contributed positively to knowledge dissemination. The existence of numerous vehicles to disseminate information, which is typical of a university setting (e.g., regular team meetings, lunch-time conferences), was reported as a facilitative factor.…”

A five-step approach for developing and implementing a Rural Primary Health Care Model for Dementia: a community–academic partnership

“…The development–adaptation process itself is time-intensive for community partners and researchers. However, our experience endorses the view that approaches that support local health care systems to adapt and adopt new knowledge are more likely to result in successful implementation and sustainability than imposing rigid adherence to an existing protocol (Callahan et al ., 2011; Richard et al ., 2015). Health care providers working in rural PHC settings have many competing demands that make it difficult to find the time and energy for intervention research that requires behavior changes.…”

The CORE (Consensus on Relevant Elements) Approach to Determining Initial Core Components of an Innovation

“…Reviews of published literature on an intervention, when there is a sufficient body of articles, can shed some light on an intervention's core components (10)(11)(12). Without knowing an intervention's core components, it will be unclear during implementation, especially when it occurs across a range of contexts, which aspects of the intervention need to be maintained when making context-appropriate modifications (13,14).…”