Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Glob Health
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 highincome
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 crosssite
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.
Description
Keywords
Cross-contextual reciprocal learning, Research project, Self-management, Type 2 diabetes
Citation
van Olmen J, Delobelle P, Guwatudde D, et al. Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes. BMJ Glob Health 2018;3:e001068. doi:10.1136/ bmjgh-2018-001068