Table 2 Description of the six components of the Basel Approach for coNtextual ANAlysis (based on Stange and Glasgow [31])
Component 1 | Choose a theory, model, or framework (TMF) to guide contextual analysis |
Considerations when selecting a TMF for contextual analysis – TMF acknowledges the multidimensional, multilevel, and dynamic nature of context – TMF fits the intervention and/or setting in which the intervention will be implemented Consider combination of a context and setting-specific TMF | |
Component 2 | Use empirical evidence to identify relevant contextual and setting factors |
Identification of empirical evidence on relevant contextual and setting factors for implementation using various sources of evidence [39] – Local data and information – Professional knowledge/clinical experience – Patient experiences and preferences – Research | |
Component 3 | Involve stakeholdera |
– Identification and listing of relevant stakeholders for contextual analysis (target group, implementers, decision-makers, others) from different levels (micro, meso, macro) – Mapping of stakeholders in a stakeholder matrix specifying their characteristics (e.g., influence, role, activity, product) – Visualizing stakeholder characteristics in an influence-interest-capacity matrix – Verifying stakeholder availability and commitment – Developing a stakeholder strategy specifying stakeholder tasks, timepoints, and methods for involvement – Evaluation of stakeholder involvement and adaption if needed | |
Component 4 | Develop a study design for contextual analysis |
Data collection is guided by theory, empirical evidence, and stakeholder input Choice of appropriate methods to answer the research questions such as – Quantitative methods (e.g., survey, routine data) – Qualitative methods (e.g., interview, focus group, observation) – (Rapid) ethnography Consider changes of context over time Plan (if possible) several timepoints for data collection (e.g., prior, during, and at the end of the project) | |
Component 5 | Determine the relevance of context for intervention co-design, choice of implementation strategies, and interpretation of outcomes |
Findings from the contextual analysis can be used for: – Development/adaption of the intervention – Choice/adaption of implementation strategies – Interpretation of implementation and effectiveness outcomes – Choice of sustainability strategies Consider the development of a program theory to describe/visualize causal pathways between intervention components, implementation strategies, and contextual factors | |
Component 6 | Report on contextual analysis |
Reporting contextual analysis as part of the implementation intervention study (detailed findings can be reported in a separate paper) Suggestions for reporting based on BANANA: – Definition of context and operationalizations of contextual and setting factors studied – TMF applied for contextual and setting analysis and description of how it was used – Overview of empirical evidence identified and used – Stakeholder involvement (i.e., stakeholder strategy) – Reporting methods applied for data collection and analysis (e.g., study design, measures used, contextual and setting factors assessed) – Use of findings from the contextual analysis for subsequent project phases (cf. component 5) |