Core components of a Community of Practice to improve community health worker performance: a qualitative study
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Implementation Science Communications
Abstract
Communities of Practice (CoPs) offer an accessible strategy for healthcare workers to improve the quality
of care through knowledge sharing. However, not enough is known about which components of CoPs are core
to facilitating behavior change. Therefore, we carried out a qualitative study to address these important gaps in the
literature on CoPs and inform planning for an interventional study of CoPs.
Methods: We organized community health workers (CHWs) from two tuberculosis (TB) clinics in Kampala, Uganda,
into a CoP from February to June 2018. We conducted interviews with CoP members to understand their perceptions
of how the CoP influenced delivery of TB contact investigation. Using an abductive approach, we first applied inductive
codes characterizing CHWs’ perceptions of how the CoP activities affected their delivery of contact investigation.
We then systematically mapped these codes into their functional categories using the Behavior Change Technique
(BCT) Taxonomy and the Behavior Change Wheel framework. We triangulated all interview findings with detailed field
notes.
Results: All eight members of the CoP agreed to participate in the interviews. CHWs identified five CoP activities as
core to improving the quality of their work: (1) individual review of feedback reports, (2) collaborative improvement
meetings, (3) real-time communications among members, (4) didactic education sessions, and (5) clinic-wide staff
meetings. These activities incorporated nine different BCTs and five distinct intervention functions. CHWs reported
that these activities provided a venue for them to share challenges, exchange knowledge, engage in group problem
solving, and benefit from social support. CHWs also explained that they felt a shared sense of ownership of the CoP,
which motivated them to propose and carry out innovations. CHWs described that the CoP strengthened their social
and professional identities within and outside the group, and improved their self-efficacy.
Conclusions: We identified the core components and several mechanisms through which CoPs may improve CHW
performance. Future studies should evaluate the importance of these mechanisms in mediating the effects of CoPs
on program effectiveness.
Description
Keywords
Community of practice, Behavior Change Technique, Intervention function, Low-income countries
Citation
Hennein, R., Ggita, J. M., Turimumahoro, P., Ochom, E., Gupta, A. J., Katamba, A., ... & Davis, J. L. (2022). Core components of a Community of Practice to improve community health worker performance: a qualitative study. Implementation Science Communications, 3(1), 1-14. https://doi.org/10.1186/s43058-022-00279-1