Adapting the IMP2ART implementation strategy to the context of primary care during a COVID-19 pandemic (ID 292)

McClatchey K, Barat A, Delaney B, Marsh V, Jackson T, Kinley E, Holmes S, Hammersley V, Steed E, Taylor, SJC, Pinnock H

The University of Edinburgh

Funding: NIHR PGfAR (RP-PG-1016-20008).

Abstract

Aim: Understanding and adapting to context is crucial if complex intervention implementation is to be successful. Within the IMP2ART programme, we developed a theoretically-informed implementation strategy to improve supported self-management (SSM) for asthma in routine practice, with a cluster-randomised trial due to start January 2020. The COVID-19 pandemic dramatically changed the context and aspects of the IMP2ART strategy required adaptation.
Methods: With input from patient and public involvement, and a professional advisory group, the team reviewed all components of the IMP2ART strategy. Changes were made to a) enable safe delivery of the strategy in a pandemic, b) to offer advice on novel modes of practice, and c) to ensure resources reflected the new context.
Results: Safe delivery of the IMP2ART strategy: Whole-practice SSM facilitation visits to implementation practices will not be possible for the foreseeable future, so we adapted this for remote delivery. Novel modes of practice: We collated resources to support remote consultations, adapting them to provide advice on remote asthma reviews. Resources were provided for both practices and patients and made available on the IMP2ART website. On-line consultations were a new format and specific advice for asthma reviews was developed. Reflecting the new context: Educational modules were updated with examples of remote reviews and remote completion of action plans.
Conclusion: Adapting the implementation strategy to the COVID-19 pandemic has been a comprehensive process. The adapted strategy is now ready for evaluation in a UK-wide cluster-RCT (n=144 practices), assessing impact and cost-effectiveness.

Conflicts of interest: None.

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