As a social scientist, Dr Girling’s research is committed to developing and applying innovative research methods that produce knowledge about how health and social problems are understood in vulnerable populations and how complex interventions are developed and implemented. Her research interests are informed by social science theory and are both academically focused as well as grounded in ‘real’ service development and innovation.
People with type 1 diabetes and raised blood sugar levels are at greater risk of health complications. NICE recommends continuous subcutaneous ‘insulin pump’ therapy for people with type 1 diabetes and high blood sugar levels. The National Diabetes Audit (NDA) has identified over 90,000 who meet these criteria but who are not using an insulin pump. Increasing the capabilities of healthcare providers to respond to feedback from national audits may improve care. The EQUIPD study is an efficient cluster randomised trial of a quality improvement collaborative (QIC) aligned to the National Diabetes Audit that seeks to enhance the improvement capabilities of feedback recipients to increase the uptake of insulin pumps in line with NICE guidance.
Over a trial period of 34 months, we are undertaking a process evaluation to understand intervention implementation, engagement, fidelity and tailoring of actions. The evaluation includes observations of QIC virtual workshops, theory-informed interviews with intervention participants, and documentary analysis (e.g., Jamboards). The analytic process will draw upon: organisational readiness to change theory to describe the target behaviours undertaken by intervention recipients; normalisation process theory (NPT) to explore how teams implement the target behaviours and, behaviour change techniques (BCTs) to describe delivery.
The process evaluation is ongoing. Initial stages have focused on coding behaviour change techniques within the intervention materials and conducting fidelity assessment of their delivery within virtual workshops. Next steps will include analysis of semi-structured interviews with intervention participants.
The process evaluation alongside an effectiveness trial provides an opportunity to describe how implementers engage with the QIC intervention overall to support improvement activity and how context influences this work (implementation and engagement); assess fidelity of delivery, receipt, and enactment of the QIC intervention (fidelity) and describe how teams enact tailoring (tailoring).