A Research Protocol for Implementation and Evaluation of a Patient-Focused eHealth Intervention for Chronic Kidney Disease

Maoliosa Donald; Heather Beanlands; Sharon Straus; Lori Harwood; Gwen Herrington; Blair Waldvogel; Maria Delgado; Dwight Sparkes; Paul Watson; Meghan Elliott; Kerry McBrien; Aminu Bello; Brenda Hemmelgarn

doi:10.1007/s43477-022-00038-3

A Research Protocol for Implementation and Evaluation of a Patient-Focused eHealth Intervention for Chronic Kidney Disease

Glob Implement Res Appl. 2022;2(1):85-94. doi: 10.1007/s43477-022-00038-3. Epub 2022 Jan 30.

Authors

Affiliations

¹ Department of Medicine, University of Calgary, HSC G239, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada.
² Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON Canada.
³ Department of Medicine, University of Toronto, Toronto, ON Canada.
⁴ London Health Sciences Centre, London, ON Canada.
⁵ Can-SOLVE CKD Patient Partner, Vancouver, BC Canada.
⁶ Department of Family Medicine, University of Calgary, Calgary, AB Canada.
⁷ Department of Medicine, University of Alberta, Edmonton, AB Canada.

Abstract

Self-management in chronic kidney disease (CKD) can slow disease progression; however, there are few tools available to support patients with early CKD. My Kidneys My Health is a patient-focused electronic health (eHealth) self-management tool developed by patients and caregivers. This study will investigate the implementation of My Kidneys My Health across primary care and general nephrology clinics. The study aims to: (1) identify and address barriers and facilitators that may impact implementation and sustainability of the website into routine clinical care; (2) evaluate implementation quality to inform spread and scale-up. We will conduct a multi-stage approach using qualitative methods, guided by the Quality Implementation Framework and using a qualitative content analysis approach. First, we will identify perceived barriers and facilitators to implementation and considerations for sustainability through interviews with clinicians, based on the Readiness Thinking Tool and the Long Term Success Tool. Analysis will be guided by the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Appropriate implementation strategies will be identified using the Expert Recommendations for Implementing Change compilation, and implementation plans will be developed based on Proctor's recommendations and the Action, Actor, Context, Target, Time framework. Finally, we will explore implementation quality guided by the RE-AIM framework. There is limited literature describing systematic approaches to implementing and sustaining patient-focused self-management tools into clinical care, in addition to employing tailored implementation strategies to promote adoption and sustainability. We aim to generate insights on how My Kidneys My Health can be integrated into clinical care and how to sustain use of patient-centric eHealth tools in clinical settings on a larger scale.

Supplementary information: The online version contains supplementary material available at 10.1007/s43477-022-00038-3.

Keywords: Chronic kidney disease; Implementation science; Person-centered care; Quality implementation framework; eHealth.