title: FIRE (Facilitating Implementation of Research Evidence): a study protocol.
abstract: BACKGROUND
  Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids.
  
  
  OBJECTIVE
  This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community.
  
  
  METHODS
  Four European countries, each with six long-term nursing care sites (total 24 sites) for people aged 60 years and over with documented urinary incontinence
  
  
  METHODS
  Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation), with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline, then at 6, 12, 18, and 24 months after the start of the facilitation interventions. Detailed contextual and process data are collected throughout, using interviews with staff, residents and next of kin, observations, assessment of context using the Alberta Context Tool, and documentary evidence. A realistic evaluation framework is used to develop explanatory theory about what works for whom in what circumstances.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN11598502.
authors.affiliation: Royal College of Nursing Research Institute, School of Health and Social Studies, University of Warwick, Coventry, UK. kate.seers@warwick.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Seers
authors.forename: Karen
authors.initials: K
authors.lastname: Cox
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Crichton
authors.forename: Rhiannon Tudor
authors.initials: RT
authors.lastname: Edwards
authors.forename: Ann Catrine
authors.initials: AC
authors.lastname: Eldh
authors.forename: Carole A
authors.initials: CA
authors.lastname: Estabrooks
authors.forename: Gill
authors.initials: G
authors.lastname: Harvey
authors.forename: Claire
authors.initials: C
authors.lastname: Hawkes
authors.forename: Alison
authors.initials: A
authors.lastname: Kitson
authors.forename: Pat
authors.initials: P
authors.lastname: Linck
authors.forename: Geraldine
authors.initials: G
authors.lastname: McCarthy
authors.forename: Brendan
authors.initials: B
authors.lastname: McCormack
authors.forename: Carole
authors.initials: C
authors.lastname: Mockford
authors.forename: Jo
authors.initials: J
authors.lastname: Rycroft-Malone
authors.forename: Angie
authors.initials: A
authors.lastname: Titchen
authors.forename: Lars
authors.initials: L
authors.lastname: Wallin
mesh_terms: D000368:Aged; D035843:Biomedical Research; D003362:Cost-Benefit Analysis; D003625:Data Collection; D003872:Dermatitis / Q000209:etiology; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D018401:Sample Size; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000191:economics / Q000628:therapy*; D014552:Urinary Tract Infections / Q000209:etiology