Skip to main content
Top
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

An analysis of the adaptability of a professional development program in public health: results from the ALPS Study

Authors: Lucie Richard, Sara Torres, Marie-Claude Tremblay, François Chiocchio, Éric Litvak, Laurence Fortin-Pellerin, Nicole Beaudet

Published in: BMC Health Services Research | Issue 1/2015

Login to get access

Abstract

Background

Professional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners’ complex real-world practice settings while preserving the core components of those programs’ models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site.

Methods

This paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization.

Results

While each team developed a unique pattern of implementing the activities, all the program’s core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process.

Conclusions

This paper shows how a professional development program model can be adapted to different contexts while preserving its core components. Capturing the heterogeneity of the intervention’s exposure, as was done here, will make possible in-depth impact analyses involving, for example, the testing of program–context interactions to identify program outcomes predictors. Such work is essential to advance knowledge on the action mechanisms of professional development programs.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bunton R, Macdonald G. Health promotion: disciplines, diversity and developments. 2nd ed. New York: Routledge; 2002. Bunton R, Macdonald G. Health promotion: disciplines, diversity and developments. 2nd ed. New York: Routledge; 2002.
2.
go back to reference Paccaud F. Educating and training the public health workforce. Eur J Public Health. 2011;21(2):137.CrossRefPubMed Paccaud F. Educating and training the public health workforce. Eur J Public Health. 2011;21(2):137.CrossRefPubMed
3.
go back to reference Guskey TR. Evaluating professional development. Thousand Oaks, CA: Corwin Press; 2000. Guskey TR. Evaluating professional development. Thousand Oaks, CA: Corwin Press; 2000.
4.
go back to reference Uwamariya A, Mukamurera J. Le concept de «développement professionnel» en enseignement: approches théoriques. Rev Sci Edu. 2005;31(1):133–55. Uwamariya A, Mukamurera J. Le concept de «développement professionnel» en enseignement: approches théoriques. Rev Sci Edu. 2005;31(1):133–55.
5.
go back to reference Bennett CM, Lilley K, Yeatman H, Parker E, Geelhoed E, Hanna EG, et al. Paving pathways: shaping the public health workforce through tertiary education. Aust New Zealand Health Policy. 2010;7:2.CrossRefPubMedPubMedCentral Bennett CM, Lilley K, Yeatman H, Parker E, Geelhoed E, Hanna EG, et al. Paving pathways: shaping the public health workforce through tertiary education. Aust New Zealand Health Policy. 2010;7:2.CrossRefPubMedPubMedCentral
6.
7.
go back to reference Koo D, Miner K. Outcome-based workforce development and education in public health. Annu Rev Public Health. 2010;31:253–69.CrossRefPubMed Koo D, Miner K. Outcome-based workforce development and education in public health. Annu Rev Public Health. 2010;31:253–69.CrossRefPubMed
8.
9.
go back to reference Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci. 2013;8:117–38.CrossRefPubMedPubMedCentral Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci. 2013;8:117–38.CrossRefPubMedPubMedCentral
10.
go back to reference Lee SJ, Altschul I, Mowbray CT. Using planned adaptation to implement evidence-based programs with new populations. Am J Community Psychol. 2008;41:290–303.CrossRefPubMed Lee SJ, Altschul I, Mowbray CT. Using planned adaptation to implement evidence-based programs with new populations. Am J Community Psychol. 2008;41:290–303.CrossRefPubMed
11.
go back to reference Webster-Wright A. Reframing professional development through understanding authentic professional learning. Rev Educ Res. 2009;79(2):702–39.CrossRef Webster-Wright A. Reframing professional development through understanding authentic professional learning. Rev Educ Res. 2009;79(2):702–39.CrossRef
12.
go back to reference Garet MS, Porter AC, Desimone L, Birman BF, Suk Yoon K. What makes professional development effective? Results from a national sample of teachers. Am Educ Res J. 2001;38(4):915–45.CrossRef Garet MS, Porter AC, Desimone L, Birman BF, Suk Yoon K. What makes professional development effective? Results from a national sample of teachers. Am Educ Res J. 2001;38(4):915–45.CrossRef
13.
go back to reference Stoll L, Bolam R, McMahon A, Wallace M, Thomas S. Professional learning communities: a review of the literature. J Educ Change. 2006;7:221–58.CrossRef Stoll L, Bolam R, McMahon A, Wallace M, Thomas S. Professional learning communities: a review of the literature. J Educ Change. 2006;7:221–58.CrossRef
14.
go back to reference Tremblay MC, Richard L. Complexity: a potential paradigm for a health promotion discipline. Health Promot Int. 2011;29(7):378–88.PubMed Tremblay MC, Richard L. Complexity: a potential paradigm for a health promotion discipline. Health Promot Int. 2011;29(7):378–88.PubMed
15.
go back to reference Hawe P, Shiell A, Riley T. Theorising interventions as events in systems. Am J Community Psychol. 2009;43(3–4):267–76.CrossRefPubMed Hawe P, Shiell A, Riley T. Theorising interventions as events in systems. Am J Community Psychol. 2009;43(3–4):267–76.CrossRefPubMed
16.
go back to reference Aarons GA, Green AE, Palinkas LA, Self-Brown S, Whitaker DJ, Lutzker JR, et al. Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implement Sci. 2012;7:32–41.CrossRefPubMedPubMedCentral Aarons GA, Green AE, Palinkas LA, Self-Brown S, Whitaker DJ, Lutzker JR, et al. Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implement Sci. 2012;7:32–41.CrossRefPubMedPubMedCentral
17.
go back to reference Morrison DM, Hoppe MJ, Gillmore MR, Kluver C, Higa D, Wells EA. Replicating an intervention: the tension between fidelity and adaptation. AIDS Educ Prev. 2009;21(2):128–40.CrossRefPubMedPubMedCentral Morrison DM, Hoppe MJ, Gillmore MR, Kluver C, Higa D, Wells EA. Replicating an intervention: the tension between fidelity and adaptation. AIDS Educ Prev. 2009;21(2):128–40.CrossRefPubMedPubMedCentral
18.
go back to reference Backer TE. Finding the balance: program fidelity and adaptation in substance abuse prevention. Rockville, MD: National Center for Advancement of Prevention; 2001. Backer TE. Finding the balance: program fidelity and adaptation in substance abuse prevention. Rockville, MD: National Center for Advancement of Prevention; 2001.
19.
go back to reference Weiss CH. How can theory-based evaluation make greater headway? Eval Rev. 1997;21(4):501–24.CrossRef Weiss CH. How can theory-based evaluation make greater headway? Eval Rev. 1997;21(4):501–24.CrossRef
21.
go back to reference Patton MQ. Developmental evaluation: applying complexity concepts to enhance innovation and use. New York, NY: The Guilford Press; 2011. Patton MQ. Developmental evaluation: applying complexity concepts to enhance innovation and use. New York, NY: The Guilford Press; 2011.
22.
go back to reference Riley BL, MacDonald J, Mansi O, Kothari A, Kurtz D, von Tettenborn L, et al. Is reporting on interventions a weak link in understanding how and why they work? A preliminary exploration using community heart health exemplars. Implement Sci. 2008;3:27–39.CrossRefPubMedPubMedCentral Riley BL, MacDonald J, Mansi O, Kothari A, Kurtz D, von Tettenborn L, et al. Is reporting on interventions a weak link in understanding how and why they work? A preliminary exploration using community heart health exemplars. Implement Sci. 2008;3:27–39.CrossRefPubMedPubMedCentral
24.
go back to reference Beaudet N, Richard L, Gendron S, Boisvert N. Advancing population-based health-promotion and prevention practice in community-health nursing: key conditions for change. ANS Adv Nurs Sci. 2011;34(4):E1–12.CrossRefPubMed Beaudet N, Richard L, Gendron S, Boisvert N. Advancing population-based health-promotion and prevention practice in community-health nursing: key conditions for change. ANS Adv Nurs Sci. 2011;34(4):E1–12.CrossRefPubMed
25.
go back to reference Breton M, Lévesque JF, Pineault R, Lamothe L, Denis JL. L’intégration de la santé publique à la gouverne locale des soins de santé au Québec: enjeux de la rencontre des missions populationnelle et organisationnelle. Prat Organ Soins. 2008;39(2):113–24. Breton M, Lévesque JF, Pineault R, Lamothe L, Denis JL. L’intégration de la santé publique à la gouverne locale des soins de santé au Québec: enjeux de la rencontre des missions populationnelle et organisationnelle. Prat Organ Soins. 2008;39(2):113–24.
26.
go back to reference Richard L, Gendron S, Beaudet N, Boisvert N, Sauvé M, Garceau-Brodeur M. Health promotion and disease prevention among nurses working in local public health organizations in Montréal, Québec. Public Health Nurs. 2010;27(5):450–8.CrossRefPubMed Richard L, Gendron S, Beaudet N, Boisvert N, Sauvé M, Garceau-Brodeur M. Health promotion and disease prevention among nurses working in local public health organizations in Montréal, Québec. Public Health Nurs. 2010;27(5):450–8.CrossRefPubMed
27.
go back to reference Tremblay MC, Brousselle A, Richard L, Beaudet N. Defining, illustrating and reflecting on logic analysis with an example from a professional development program. Eval Program Plann. 2013;40(1):64–73.CrossRefPubMed Tremblay MC, Brousselle A, Richard L, Beaudet N. Defining, illustrating and reflecting on logic analysis with an example from a professional development program. Eval Program Plann. 2013;40(1):64–73.CrossRefPubMed
28.
go back to reference Tremblay M-C, Richard L, Brousselle A, Beaudet N. How can both the intervention and its evaluation fulfill health promotion principles? An example from a professional development program. Health Promot Pract. 2013;14(4):563–71.CrossRefPubMed Tremblay M-C, Richard L, Brousselle A, Beaudet N. How can both the intervention and its evaluation fulfill health promotion principles? An example from a professional development program. Health Promot Pract. 2013;14(4):563–71.CrossRefPubMed
29.
go back to reference Berkowitz B, Nicola R. Public health infrastructure system change: outcomes from the turning point initiative. J Public Health Manag Pract. 2003;9(3):224–7.CrossRefPubMed Berkowitz B, Nicola R. Public health infrastructure system change: outcomes from the turning point initiative. J Public Health Manag Pract. 2003;9(3):224–7.CrossRefPubMed
30.
go back to reference Brookes K, Davidson P, Daly J, Hancock K. Community health nursing in Australia: a critical literature review and implications for professional development. Contemp Nurse. 2004;16(3):195–207.CrossRefPubMed Brookes K, Davidson P, Daly J, Hancock K. Community health nursing in Australia: a critical literature review and implications for professional development. Contemp Nurse. 2004;16(3):195–207.CrossRefPubMed
31.
go back to reference Westbrook L, Schultz P. From theory to practice: community health nursing in a public health neighborhood team. ANS Adv Nurs Sci. 2000;23(2):50–61.CrossRefPubMed Westbrook L, Schultz P. From theory to practice: community health nursing in a public health neighborhood team. ANS Adv Nurs Sci. 2000;23(2):50–61.CrossRefPubMed
32.
go back to reference Lafortune L. Guide pour l’accompagnement professionnel d’un changement. Montréal: Presses de l’Université du Québec; 2008. Lafortune L. Guide pour l’accompagnement professionnel d’un changement. Montréal: Presses de l’Université du Québec; 2008.
33.
go back to reference Brousselle A, Champagne F. Program theory evaluation: logic analysis. Eval Program Plann. 2011;34(1):69–78.CrossRefPubMed Brousselle A, Champagne F. Program theory evaluation: logic analysis. Eval Program Plann. 2011;34(1):69–78.CrossRefPubMed
34.
go back to reference Champagne F, Brousselle A, Contandriopoulos AP, Hartz Z. L’analyse logique. In: Brousselle A, Champagne F, Contandriopoulos AP, Hartz Z, editors. L’évaluation: concepts et méthodes. Montréal: Les Presses de l’Université de Montréal; 2009. p. 101–33. Champagne F, Brousselle A, Contandriopoulos AP, Hartz Z. L’analyse logique. In: Brousselle A, Champagne F, Contandriopoulos AP, Hartz Z, editors. L’évaluation: concepts et méthodes. Montréal: Les Presses de l’Université de Montréal; 2009. p. 101–33.
35.
go back to reference Richard L, Chiocchio F, Essiembre H, Tremblay MC, Lamy G, Champagne F, et al. Communities of practice as a professional and organizational development strategy in local public health organizations in Québec, Canada: an evaluation model. Healthc Policy. 2014;9(3):26–39.PubMedPubMedCentral Richard L, Chiocchio F, Essiembre H, Tremblay MC, Lamy G, Champagne F, et al. Communities of practice as a professional and organizational development strategy in local public health organizations in Québec, Canada: an evaluation model. Healthc Policy. 2014;9(3):26–39.PubMedPubMedCentral
36.
go back to reference Durlak JA. Why program implementation is important. J Prev Interv Community. 1998;17(2):5–18.CrossRef Durlak JA. Why program implementation is important. J Prev Interv Community. 1998;17(2):5–18.CrossRef
37.
go back to reference Kirsh SR, Lawrence RH, Aron DC. Tailoring an intervention to the context and system redesign related to the intervention: a case study of implementing shared medical appointments for diabetes. Implement Sci. 2008;3:34.CrossRefPubMedPubMedCentral Kirsh SR, Lawrence RH, Aron DC. Tailoring an intervention to the context and system redesign related to the intervention: a case study of implementing shared medical appointments for diabetes. Implement Sci. 2008;3:34.CrossRefPubMedPubMedCentral
38.
go back to reference Durlak J, DuPre E. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50.CrossRefPubMed Durlak J, DuPre E. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50.CrossRefPubMed
39.
go back to reference Chaudoir S, Dugan A, Barr C. Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures. Implement Sci. 2013;8(22):1–20. Chaudoir S, Dugan A, Barr C. Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures. Implement Sci. 2013;8(22):1–20.
40.
go back to reference Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: what it is and how to do it. BMJ. 2013;347. Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: what it is and how to do it. BMJ. 2013;347.
Metadata
Title
An analysis of the adaptability of a professional development program in public health: results from the ALPS Study
Authors
Lucie Richard
Sara Torres
Marie-Claude Tremblay
François Chiocchio
Éric Litvak
Laurence Fortin-Pellerin
Nicole Beaudet
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0903-3

Other articles of this Issue 1/2015

BMC Health Services Research 1/2015 Go to the issue