Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
Josefien van Olmen,
Kerstin Klipstein-Grobusch,
Por Ir,
Wim Van Damme,
Roy Remmen,
Edwin Wouters,
Veerle Buffel,
Srean Chhim,
Grace Marie V Ku,
Daniel Boateng,
Monika Martens,
Zalika Klemenc Ketiš,
Savina Chham,
Katrien Danhieux,
Nataša Stojnić,
Črt Zavrnik,
Antonija Poplas Susič
Affiliations
Josefien van Olmen
Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
Kerstin Klipstein-Grobusch
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
Por Ir
National Institute of Public Health, Phnom Penh, Cambodia
Wim Van Damme
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
Roy Remmen
Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
Edwin Wouters
4 Department of Sociology, Centre for Population, Family & Health, University of Antwerp, Antwerpen, Belgium
Veerle Buffel
Centre for Population, Family & Health, Department of Social Sciences, University of Antwerp, Antwerp, Belgium
Srean Chhim
National Institute of Public Health, Phnom Penh, Cambodia
Grace Marie V Ku
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
Daniel Boateng
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
Monika Martens
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
Zalika Klemenc Ketiš
Community Health Center Ljubljana, Ljubljana, Slovenia
Savina Chham
Centre for Population, Family & Health, Department of Social Sciences, University of Antwerp, Antwerp, Belgium
Katrien Danhieux
Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
Nataša Stojnić
Community Health Center Ljubljana, Ljubljana, Slovenia
Črt Zavrnik
Community Health Center Ljubljana, Ljubljana, Slovenia
Antonija Poplas Susič
Community Health Center Ljubljana, Ljubljana, Slovenia
Introduction Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project. The specific goals of the process and scale-up evaluation are to (1) analyse how, and to what extent, the roadmap has been implemented, (2) assess how the differing contexts can influence the implementation process of the scale-up strategies and (3) assess the progress of the scale-up.Methods and analysis A comprehensive framework was developed to include process and scale-up evaluation embedded in implementation science theory. Key implementation outcomes include acceptability, feasibility, relevance, adaptation, adoption and cost of roadmap activities. A diverse range of predominantly qualitative tools—including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping—were developed to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. The role of context is considered relevant, and barriers and facilitators to scale-up will be continuously assessed.Ethics and dissemination Ethical approval has been obtained from the Institutional Review Board (ref. 1323/19) at the Institute of Tropical Medicine (Antwerp, Belgium). The SCUBY Project presents a comprehensive framework to guide the process and scale-up evaluation of complex interventions in different health systems. We describe how implementation outcomes, mechanisms of impact and scale-up outcomes can be a basis to monitor adaptations through a co-creation process and to guide other scale-up interventions making use of knowledge translation and co-creation activities.
