Masterson Algar, Patricia and Rycroft-Malone, Joanne and Burton, Christopher and Sackley, Catherine and Walker, Marian (2013) OTCH trial process evaluation : factors mediating the delivery of the OTCH intervention according to the protocol. In: SRR Winter Meeting, 2013-02-05 - 2013-02-05.
Full text not available from this repository.Abstract
Background: A cluster randomized controlledtrial with residents with stroke in care homes(OTCH) aims to evaluate the impact of a complexoccupational therapy intervention focused on promotingindependence via activities of daily living. Aprocess evaluation is running alongside the OTCHtrial to examine intervention fidelity.Method: An explanatory programme theory ofintervention fidelity which integrates aspects ofimplementation and anticipated impacts has beenconstructed to underpin the process evaluation.The theory is being tested drawing on both indepthsemi-structured interviews (n = 17) andreports of critical incidents from the trial (n = 20)with all occupational therapists.Results/findings: A key theme emerging from theprocess evaluation relates to how occupationaltherapists have had to balance the requirements ofdelivering the OTCH trial intervention within bothcare home and research contexts simultaneously.Occupational therapists’ previous experiences,characteristics of patients allocated to the trial andthe managerial structure of the care homes werethe factors that influenced how successful occupationaltherapists were in achieving this balance.Discussion: Occupational therapists with previousresearch experience were more cognisant ofthe study outcome measures, and used them toguide patients’ goal setting. Occupational therapistswith extensive professional (non-research)experience reported more confidence in their abilityto tailor more peripheral components of theintervention, or to target goals outside the scopeof the trial intervention.Conclusion: This process evaluation illuminatesthe complexities in considering the fidelity of rehabilitationtrial interventions, specifically in how therapistexperience may influence implementation.