gms | German Medical Science

Background: To improve health care services in a specific country, region or organization, the conditions of the target context need to be considered. Decisions for the implementation of a health intervention are commonly informed by research conducted in other contexts than the target context. However, health interventions, which have proven to be effective in the research context, may not effectively work in the country, region or organization of interest. In the international literature, a need for validated criteria and guidance for the assessment of transferability is expressed [1], [2], [3].

Research question and objective: What criteria influence the transferability of health interventions? The aim was to develop a theoretical model to assist decision makers in the assessment of transferability of health interventions between different contexts.

Methods: A systematic literature search was performed in the databases PubMed, Embase, CINAHL, and PsycINFO in 2016. Articles were eligible if they were published in English or German and provided a description of transferability criteria. Included articles were ranked based on their thematic relevance and methodological support of transferability criteria. Using a qualitative approach, a thematic synthesis was conducted.

Results: After screening of 2275 articles, 37 were included. The thematic synthesis revealed 44 criteria, covered by 4 overarching themes, which influence transferability of health interventions: The population (P), the intervention (I), and the environment (E) represent 30 conditional transferability criteria, and the transfer of the intervention (T) represents 14 process criteria for transferring the intervention to the target context. Transferability (-T) depends on the dynamic interaction of conditional criteria in the primary and target context as well as on the process of transfer. The synthesis resulted in two related models: the conceptual PIET-T model explains the underlying mechanism of transferability and the PIET-T process model provides practical guidance for a transferability assessment.

Discussion: Transferability of a health intervention depends on contextual influences. It should be anticipated before and evaluated after an intervention is implemented in the target context. The synthesized PIET-T models are intended as a theoretical basis to determine transferability. Further research is ongoing to develop a practical tool for the PIET-T models.

Practical implications: An important prerequisite for decision-making and implementation of a health intervention is the determination of influences and actions for the success of the intervention in the target context. Here the PIET-T models can offer systematic help.