Dr Jane Murphy is a Postdoctoral Researcher on the CUSTOMISE (Comparing and Understanding Tailoring Methods for Implementation Strategies) project in the Health Implementation Research Hub at the School of Public Health, University College Cork. In CUSTOMISE, she is leading the evaluation of the tailoring approach for an ongoing national study developing tailored strategies to enhance the implementation of Dose Adjustment for Normal Eating (DAFNE), a patient education programme for people living with type 1 diabetes. Dr Murphy is also working on an update of a Cochrane review on tailored interventions to address determinants of professional practice, along with a scoping review to characterise the processes and outcomes of tailoring in healthcare. Prior to this, she worked as a Postdoctoral Researcher on the Horizon2020 SEURO (Scaling EUROpean citizen driven transferable and transformative digital health) project at Trinity College Dublin. Dr Murphy completed her PhD in the School of Psychology at University of Galway in 2021. Her PhD research employed multiple methods to evaluate the role of digital health interventions to support medication adherence in young adults living with asthma. Dr Murphy’s research interests include management of chronic conditions across the lifespan, digital health and implementation science.
Tailored implementation strategies effectively support implementation of interventions in healthcare. However, it is unknown which tailoring approaches are most feasible and acceptable to stakeholders and which outcomes they consider important. Dose Adjustment for Normal Eating (DAFNE) is an evidence-based patient education programme recommended for type 1 diabetes management, however its implementation and how best to support delivery are underexplored. Using DAFNE as a case study, we evaluated clinical stakeholder’s experiences of the process to tailor strategies to support programme implementation.
DAFNE clinical teams participated in a tailoring process involving three group discussions to prioritise determinants and select implementation strategies. Employing a mixed methods convergent design, participants’ experiences of tailoring are evaluated using multiple data sources (observation notes, surveys, interviews). Findings are integrated using a triangulation protocol. Data are combined using joint displays for within and cross-case analysis.
In total 8 DAFNE centres in Ireland comprising 40 clinicians have participated to date in the tailoring process. Teams prioritised determinants important to address now, including lack of available resources (administration support), access to knowledge and information (familiarity with course content), and networking and communication (long-standing relationships). A total of 27 clinicians from 7 centres have completed post-tailoring evaluation interviews to date. Findings from these interviews suggest the process is acceptable and feasible to clinicians, facilitating a dedicated opportunity to discuss DAFNE. However, additional guidance and evidence were not often used when prioritising determinants.
The findings will inform best-practices for developing tailoring approaches which are feasible and acceptable to clinical stakeholders, and which incorporate the guidance and evidence they use and value to make decisions during tailoring.