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A typology of practice narratives during the implementation of a preventive, community intervention trial.

Riley T, Hawe P - Implement Sci (2009)

Bottom Line: This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness.It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern.The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions.

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Affiliation: Centre for Health and Society, Melbourne School of Population Health, The University of Melbourne, Level 4, 207 Bouverie St, Carlton, Victoria, 3010, Australia. triley@unimelb.edu.au

ABSTRACT

Background: Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness.

Methods: We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory.

Results: Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type.

Conclusions: The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions.

No MeSH data available.


The collapsing of individual narratives into a typology.
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Figure 1: The collapsing of individual narratives into a typology.

Mentions: Analysing plot structure is a common form of narrative analysis [31]. However, codifying narrative data is difficult [31]. The analyst cannot afford to decontextualise the data (as in thematic analysis) while looking for larger meaning structures that make up a narrative. The context in which a narrative is constructed becomes a part of the narrative itself [22]. So, coding was undertaken in two ways. Firstly, sensitizing narrative concepts such as whether the text was descriptive or evaluative in nature [35] were used to assist in applying a narrative lens to the data. Primary coding consisted of analytic notes attached to sections of text. These analytic notes comprised statements or evaluations of narrative structure and subsequent themes. A set of narrative questions/themes guided this analysis [18] such as how the practitioner position themselves in the telling of the story and the context of the story telling occasion [22] This approach to handling the data is consistent with the phenomenological aim of understanding the meaning people give to their lives in context and over time [32,36]. For a detailed description of methods see [18]. The two-stage analysis culminated first in the construction of eight individual narratives. Each practitioner narrative was then abstracted further into one of five types that make up the typology, as shown in Figure 1. Practitioner narratives were connected to a type if they encompassed many (but not necessarily all) of the characteristics of the type. Practitioner two was the only exception, encompassing key characteristics of three types.


A typology of practice narratives during the implementation of a preventive, community intervention trial.

Riley T, Hawe P - Implement Sci (2009)

The collapsing of individual narratives into a typology.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2803442&req=5

Figure 1: The collapsing of individual narratives into a typology.
Mentions: Analysing plot structure is a common form of narrative analysis [31]. However, codifying narrative data is difficult [31]. The analyst cannot afford to decontextualise the data (as in thematic analysis) while looking for larger meaning structures that make up a narrative. The context in which a narrative is constructed becomes a part of the narrative itself [22]. So, coding was undertaken in two ways. Firstly, sensitizing narrative concepts such as whether the text was descriptive or evaluative in nature [35] were used to assist in applying a narrative lens to the data. Primary coding consisted of analytic notes attached to sections of text. These analytic notes comprised statements or evaluations of narrative structure and subsequent themes. A set of narrative questions/themes guided this analysis [18] such as how the practitioner position themselves in the telling of the story and the context of the story telling occasion [22] This approach to handling the data is consistent with the phenomenological aim of understanding the meaning people give to their lives in context and over time [32,36]. For a detailed description of methods see [18]. The two-stage analysis culminated first in the construction of eight individual narratives. Each practitioner narrative was then abstracted further into one of five types that make up the typology, as shown in Figure 1. Practitioner narratives were connected to a type if they encompassed many (but not necessarily all) of the characteristics of the type. Practitioner two was the only exception, encompassing key characteristics of three types.

Bottom Line: This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness.It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern.The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Health and Society, Melbourne School of Population Health, The University of Melbourne, Level 4, 207 Bouverie St, Carlton, Victoria, 3010, Australia. triley@unimelb.edu.au

ABSTRACT

Background: Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness.

Methods: We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory.

Results: Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type.

Conclusions: The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions.

No MeSH data available.