Understanding context: A concept analysis

Abstract

Aims To conduct a concept analysis of clinical practice contexts (work environments) in health care. Background Context is increasingly recognized as important to the development, delivery, and understanding of implementation strategies; however, conceptual clarity about what comprises context is lacking. Design Modified Walker and Avant concept analysis comprised of five steps: (1) concept selection; (2) determination of aims; (3) identification of uses of context; (4) determination of its defining attributes; and (5) definition of its empirical referents. Methods A wide range of databases were systematically searched from inception to August 2014. Empirical articles were included if a definition and/or attributes of context were reported. Theoretical articles were included if they reported a model, theory, or framework of context or where context was a component. Double independent screening and data extraction were conducted. Analysis was iterative, involving organizing and reorganizing until a framework of domains, attributes. and features of context emerged. Result We identified 15,972 references, of which 70 satisfied our inclusion criteria. In total, 201 unique features of context were identified, of these 89 were shared (reported in two or more studies). The 89 shared features were grouped into 21 attributes of context which were further categorized into six domains of context. Conclusion This study resulted in a framework of domains, attributes and features of context. These attributes and features, if assessed and used to tailor implementation activities, hold promise for improved research implementation in clinical practice.

Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

“…While individuals' demographic characteristics have previously been classi ed as one element of context [6], there has been limited discussion regarding the broader social implications of these demographics and especially their intersections.…”

Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

“…While an individual's demographic characteristics have previously been classified as one element of context [9], there has been limited discussion regarding the broader social implications of these demographics and especially their intersections. Intersectionality is more than just identifying independent sociodemographic factors -it is about the synergy of these factors within the individual as they relate to broader societal system.…”

“…When applying the TDF (or any MTF), it is critical to understand the context in which behaviours occur [8][9][10]. Recently, KT researchers have called for greater incorporation of social and structural factors to enhance our understanding of the contextual influences on behaviour.…”

Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

“…While individuals' demographic characteristics have previously been classi ed as one element of context [6], there has been limited discussion regarding the broader social implications of these demographics and especially their intersections. Intersectionality is more than just identifying independent sociodemographic factors -it is about the synergy of these factors within the individual as they relate to broader societal system.…”