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Tool helps implement projects based on scientific evidence

King's College London checklist adapted by a Brazilian team and translated into Portuguese

King’s College London, one of the oldest universities in England, has begun offering the Portuguese version of its Implementation Science Research Development (IMPRES) tool, which has been adapted and validated for the Brazilian reality by researchers from the University of Campinas (UNICAMP). Available at Guia KI Science, the tool provides a type of checklist that enables the researcher to use the main concepts formulated by a field of studies known as implementation science in their project and monitor their results. Implementation science seeks to facilitate the dissemination of evidence-based practices, identifying obstacles to their adoption, and testing the efficiency of interventions designed to remove these obstacles. Its methodologies are useful in areas such as education and management, but it is in public health that they have been most applied (see Pesquisa FAPESP issue no. 312).

The English version of IMPRES was created by psychologist Louise Hull, from the King’s College Center of Implementation Science, and has already been downloaded over 3,000 times. It was translated and adapted for Brazil by a group from the School of Medical Sciences (FCM) at UNICAMP that was looking for theoretical support for a recently completed project aimed at integrating primary care and mental health networks in the municipality of Itatiba, in the state of São Paulo. Nurse Carlos Alberto Treichel was doing his PhD at FCM-UNICAMP when he spent a sandwich period at King’s College to study implementation science in more depth. He became familiar with the tool and brought it to be tested in Brazil. “It was a horizontal collaboration, in which the contribution from Brazilian researchers enabled the methodology to be validated in a new country and helped strengthen it,” explains physician Rosana Teresa Onocko-Campos, advisor to Treichel and researcher at FCM-UNICAMP, where she runs the laboratory Public Health and Mental Health: Interfaces.

“We are promoting the tool through courses for health professionals and in postgraduate programs,” says Treichel. The Institute of Health (IS), linked to the São Paulo State Health Department (SES-SP), is also using IMPRES in courses for professionals from the Brazilian public health system (SUS). Pharmaceutical biochemist Priscilla Alves Rocha, who coordinates the pharmaceutical care area of the Central Institute of the Hospital das Clínicas of São Paulo, uses the tool in her professional master’s project, under the guidance of physician Tereza Toma, in a postgraduate program in public health of the IS.

The project seeks to assess the implementation of a pharmaceutical telecare service for patients with hepatitis B. The service involves guiding and monitoring the use of medications to achieve the best effect. “In any treatment of chronic illness, the adhesion to the medications tends to fluctuate,” explains Rocha. “In the case of hepatitis B, it is just a pill, but the patient doesn’t always take it regularly. If they take it on 90% of the days, the risk of developing hepatic cancer is much less than if they take it on 70%. Hence the importance of monitoring them, to ensure the best possible adhesion.”

The service was provided in person, but moved to being done remotely during the pandemic and is now available in both formats. The objective is to assess how much it is working. “The tool presents concepts and suggests strategies that should be followed in an implementation study and helped me organize the project. The checklist enables not only the level of adhesion and the satisfaction of the users to be analyzed, but other important variables, such as costs, viability, capacity to reproduce the experience in other environments, and the reasons that lead some people to not use the service,” explains Rocha. Data collection is underway and the analysis of the results from the survey should be released by August 2023.