A realist evaluation of a training programme to enable therapists to implement a complex rehabilitation intervention in a research setting
What we are doing?
A realist evaluation of a package of training and support currently being used to enable occupational therapists, physiotherapists and support workers to implement a complex rehabilitation intervention as part of a multi-site randomized controlled trial. Methods will be a scoping review to identity learning theories used to enable therapist to develop clinical skills. An exploratory interviews study to begin to understand themes and mechanisms from the therapist’s perspective. Quantitative analysis of video recorded therapy sessions to determine whether the intervention was implemented as intended. Finally, realist interviews to establish what are facilitators or barriers to the implementation of the intervention.
Why we are doing it?
Multi-site randomized controlled trials are the most highly regarded method of researching therapeutic approaches for allied health professionals. Clinical guideline recommendations for delivering evidence based practice are developed on the strength of such trials. A number of RCTs for complex rehabilitation interventions have had neutral results when rolled out to multiple sites. Training for those delivering these interventions is variable and inconsistently reported. It has also been offered as potential reasons for the results. This study aims to develop guidelines to enable therapists to consistently deliver the same complex rehabilitation interventions over multiple sites for the purpose of research studies.
What the benefits will be and to whom?
This project will benefit the participants and therapists taking part in the current research trial this PhD is situated within. Improving outcomes for this patient group will also have a positive impact on their family, carers and future health and social care use. The guidelines developed could be utilised by other projects, increasing the efficacy of other research trials, impacting the quality of rehabilitation services and clinical outcomes for multiple patient groups. The guidelines could increase the number of therapists and participants becoming involved in research as they will trust they are receiving high quality guidance on implementing new interventions.
Who we are working with?
The project is researching training and support being provided to therapists across multiple sites in the UK, delivering the PrAISED (Promoting Activity Independence and Stability in Early Dementia) intervention through the University of Nottingham. These therapists will be the participants for this PhD. The supervisory team are experienced in conducting randomized controlled trials for rehabilitation therapists and using realist evaluation methods. To increase the rigour of the study, there will be a stakeholder group made up of PPI representatives, representatives of clinical therapists delivering the intervention, representatives of academic therapists who conduct similar research and those experienced in realist methods.
Contact
Louise Howe, Research Assistant and PhD Student, University of Nottingham, louise.howe@nottingham.ac.uk.