ArticleImplementation science : IS2015
Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.
Article in Implementation science : IS, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 68 citations in OpenAlex.
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- Exploring the effect of implementation and context on a stepped-wedge randomised controlled trial of a vital sign triage device in routine maternity care in low-resource settings.Implementation science : IS · 2019Trial
- Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol.Implementation science : IS · 2017Trial
- Participatory system dynamics modeling: advancing equity through contextualized implementation science in global health.BMC global and public health · 2026Review
- Family systems care approaches and methodologies for maternal, newborn and child health in low- and middle-income countries: a scoping review.Global health action · 2025Article
- Context matters: examining factors influencing the implementation of evidence-based family systems care for small and sick newborns across the care continuum.Frontiers in health services · 2025Article
- Implementation Science's Role in Community Engagement for Substance Use Prevention.Journal of prevention (2022) · 2024Article
- Context factors for implementation of clinical recommendations for chronic musculoskeletal pain.African journal of primary health care & family medicine · 2024Article
- Article
- A scoping review of implementation science theories, models, and frameworks - an appraisal of purpose, characteristics, usability, applicability, and testability.Implementation science : IS · 2023Article
- Challenges and opportunities for implementation and dissemination of a task- sharing counselling intervention for depression at primary health care level in South Africa.International journal of mental health systems · 2023Article
- Perceptual differences in nursing implementation leadership and climate: a cross-sectional study.Implementation science communications · 2023Article
- A new measure for multi-professional medical team communication: design and methodology for multilingual measurement development.Frontiers in pediatrics · 2023Article
- Understanding context in the implementation of emergency obstetric and neonatal care in health facilities in Osun State, Nigeria- a mixed-methods study.BMC pregnancy and childbirth · 2022Article
- The Challenges of Establishing Healthcare Services in Low- and Middle-Income Countries: The Case of Autism Spectrum Disorders (ASD) in the Kurdistan Region of Iraq-Report from the Field.Brain sciences · 2022Review
- Improving facility-based care: eliciting tacit knowledge to advance intervention design.BMJ global health · 2022Article
- Developing Capacity in Dissemination and Implementation Research in the Eastern Mediterranean Region: Evaluation of a Training Workshop.Global implementation research and applications · 2022Article
- Learning needs assessment for multi-stakeholder implementation science training in LMIC settings: findings and recommendations.Implementation science communications · 2021Article
- Community health workers at the dawn of a new era: 10. Programme performance and its assessment.Health research policy and systems · 2021Review
- A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB Services: Lessons Learned From KwaZulu-Natal, South Africa.Global health, science and practice · 2021Article
Corrections and comments
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Authors and funding
19 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose.
methodsThe development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries.
resultsThe tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge.
conclusionsAspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.