Methodology

Healthcare professionals and managers' participation in developing an intervention: A pre-intervention study in the elderly care context

Isabelle Vedel^1,2,3 , Matthieu De Stampa^1,2 , Howard Bergman^2,4 , Joel Ankri¹ , Bernard Cassou¹ , François Blanchard⁵ and Liette Lapointe^3,2

¹  Université de Versailles St-Quentin, Laboratoire Santé Vieillissement, AP-HP, Hôpital Sainte Perine, 49 rue Mirabeau 75016 Paris, France

²  Solidage, McGill University – Université de Montréal Research Group on Frailty and Aging, 3755 Ch. Côte Ste Catherine, Montréal H3T 1B3, Québec, Canada

³  Desautels Faculty of Management, McGill University, 1001 Sherbrooke St West Montreal, QC H3A 1G5, Canada

⁴  Division of Geriatric Medicine, Jewish General Hospital, McGill University, 3755 Ch. Côte Ste Catherine, Montréal H3T 1B3, Québec, Canada

⁵  Université de Reims Champagne Ardennes, Laboratoire Santé Publique, Vieillissement et troubles cognitifs et du comportement, Hôpital Maison Blanche 45, rue Cognacq-Jay 51092 Reims, France

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Implementation Science 2009, 4:21doi:10.1186/1748-5908-4-21

Published:	21 April 2009

Abstract

Background

In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention.

Methods

A qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation.

Results

The stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations.

Conclusion

This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the insight of healthcare professionalnd managers and emphasizes the need to intervene at different levels. Further research will be needed in order to develop a more thorough understanding of the impacts of such strategies on the final outcomes of intervention implementations.