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van Olmen J, Delobelle P, Guwatudde D, et al. Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes. BMJ Glob Health. 2018;3(6):e001068doi: 10.1136/bmjgh-2018-001068.
van Olmen, J., Delobelle, P., Guwatudde, D., Absetz, P., Sanders, D., Mölsted Alvesson, H., Puoane, T., Ostenson, C. G., Tomson, G., Mayega, R. W., Sundberg, C. J., Peterson, S., & Daivadanam, M. (2018). Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes. BMJ global health, 3(6), e001068. https://doi.org/10.1136/bmjgh-2018-001068
van Olmen, Josefien, et al. "Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes." BMJ global health vol. 3,6 (2018): e001068. doi: https://doi.org/10.1136/bmjgh-2018-001068
van Olmen J, Delobelle P, Guwatudde D, Absetz P, Sanders D, Mölsted Alvesson H, Puoane T, Ostenson CG, Tomson G, Mayega RW, Sundberg CJ, Peterson S, Daivadanam M. Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes. BMJ Glob Health. 2018 Nov 26;3(6):e001068. doi: 10.1136/bmjgh-2018-001068. eCollection 2018. PMID: 30555727; PMCID: PMC6267315.
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BMJ Glob Health. 2018 Nov 26;3(6):e001068. doi: 10.1136/bmjgh-2018-001068. eCollection 2018.

Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes.

BMJ global health

Josefien van Olmen, Peter Delobelle, David Guwatudde, Pilvikki Absetz, David Sanders, Helle Mölsted Alvesson, Thandi Puoane, Claes-Goran Ostenson, Göran Tomson, Roy William Mayega, Carl Johan Sundberg, Stefan Peterson, Meena Daivadanam

Affiliations

  1. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
  2. Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
  3. Chronic Disease Initiative for Africa, Faculty of Health Sciences - University of Cape Town, Cape Town, South Africa.
  4. School of Public Health, University of Western Cape, Bellville, South Africa.
  5. Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
  6. Department of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
  7. Collaborative Care Systems Finland, Helsinki, Finland.
  8. School of Public Health, University of the Western Cape, Cape Town, South Africa.
  9. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
  10. Department of Molecular Medicine and Surgery, Diabetes and Endocrine Unit, Karolinska Institutet, Stockholm, Sweden.
  11. Department of Public Health Sciences, Karolinska Institutet and Swedish Institute for Global Health Transformation (SIGHT), Stockholm, Sweden.
  12. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
  13. Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
  14. Uppsala University, Uppsala, Sweden.
  15. Dept of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.

PMID: 30555727 PMCID: PMC6267315 DOI: 10.1136/bmjgh-2018-001068

Abstract

This paper reports on the use of reciprocal learning for identifying, adopting and adapting a type 2 diabetes self-management support intervention in a multisite implementation trial conducted in a rural setting in a low-income country (Uganda), a periurban township in a middle-income country (South Africa) and socioeconomically disadvantaged suburbs in a high-income country (Sweden). The learning process was guided by a framework for knowledge translation and structured into three learning cycles, allowing for a balance between evidence, stakeholder interaction and contextual adaptation. Key factors included commitment, common goals, leadership and partnerships. Synergistic outcomes were the cocreation of knowledge, interventions and implementation methods, including reverse innovations such as adaption of community-linked models of care. Contextualisation was achieved by cross-site exchanges and local stakeholder interaction to balance intervention fidelity with local adaptation. Interdisciplinary and cross-site collaboration resulted in the establishment of learning networks. Limitations of reciprocal learning relate to the complexity of the process with unpredictable outcomes and the limited generalisability of results.

Keywords: community interventions; diabetes; global health; health policies; health services research; health systems; implementation research; international collaboration; low and middle income country; multi-country study; prevention strategies; research partnerships; reverse innovation; self-management; type 2 diabetes

Conflict of interest statement

Competing interests: None declared.

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