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Eval Program Plann. 2019 Jan 14;73:163-175. doi: 10.1016/j.evalprogplan.2019.01.002. [Epub ahead of print]

How was a national moving and handling people guideline intended to work? The underlying programme theory.

Author information

1
Centre for Ergonomics, Occupational Safety and Health, School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand. Electronic address: m.lidegaard@massey.ac.nz.
2
Centre for Ergonomics, Occupational Safety and Health, School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.

Abstract

In healthcare, moving and handling people (MHP) often cause musculoskeletal disorders. To prevent musculoskeletal disorders due to MHP, many national evidence-based guidelines have been developed. However, little is known about how these guidelines were intended to work, i.e. their 'programme theory', how implementation by intended users is influenced by contextual factors and mechanisms to produce outcomes. This paper identifies the programme theory of a national MHP guideline (MHPG) using thematic analysis of the MHPG document, three organisational planning documents, and interviews with MHPG developers. The analysis identified the intended users of the MHPG as health and safety managers and MHP coordinators. The programme theory comprised contextual factors, potentially hindering (e.g. budget constraints) or facilitating (e.g. changing demographics) implementation, being influenced by mechanisms mainly based on ethical (quality of care, evidence-based practices), and economic reasoning (reducing cost of MHP, return on investment) to reduce injuries caused by MHP - the intended outcome.

KEYWORDS:

CMO configuration; Contextual factors; Healthcare sector; Implementation research; Reasoning

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