Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes

Josefien van Olmen, Peter Delobelle, David Guwatudde, Pilvikki Absetz, David Sanders, Helle Mölsted Alvesson, Thandi Puoane, Claes-Goran Ostenson, Göran Tomson, Roy William Mayega, Carl Johan Sundberg, Stefan Peterson, Meena Daivadanam

Research output: Contribution to journalA2: International peer reviewed article (not A1-type)

Abstract

This paper reports on the use of reciprocal learning for identifying, adopting and adapting a type 2 diabetes self-management support intervention in a multisite implementation trial conducted in a rural setting in a low-income country (Uganda), a periurban township in a middle-income country (South Africa) and socioeconomically disadvantaged suburbs in a high-income country (Sweden). The learning process was guided by a framework for knowledge translation and structured into three learning cycles, allowing for a balance between evidence, stakeholder interaction and contextual adaptation. Key factors included commitment, common goals, leadership and partnerships. Synergistic outcomes were the cocreation of knowledge, interventions and implementation methods, including reverse innovations such as adaption of community-linked models of care. Contextualisation was achieved by cross-site exchanges and local stakeholder interaction to balance intervention fidelity with local adaptation. Interdisciplinary and cross-site collaboration resulted in the establishment of learning networks. Limitations of reciprocal learning relate to the complexity of the process with unpredictable outcomes and the limited generalisability of results.

Original languageEnglish
Article numbere001068
JournalBMJ Global Health
Volume3
Issue number6
Number of pages9
ISSN2059-7908
DOIs
Publication statusPublished - 2018

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