PROLIFERATE Framework: A simplified guide for research and stakeholder engagement evaluation

This guide simplifies the PROLIFERATE framework, emphasising stakeholder engagement in evaluating innovations, interventions, procedures, and research products' impacts.

PROLIFERATE is an adaptable framework for evaluating health services and consumer engagement research. It actively involves stakeholders from various backgrounds to tailor the evaluation process according to their unique needs, objectives, contexts, and co-defined benchmarks.

This guide explains the evaluation development (co-design process via the creation of a transdisciplinary group) as PROLIFERATE's adaptive nature involves collaborative efforts among stakeholders through various means, such as online communication or in-person meetings, extending to data collection methods outside the transdisciplinary group. This iterative process allows stakeholders to integrate their perspectives as hypotheses, which are then tested through data collection and analysis.

PROLIFERATE employs three logical approaches:

1. Ecological Logic: Views health systems as dynamic networks, measuring structures, patterns, and functions across different stages of knowledge translation and stakeholder types.
2. Mechanistic Logic: Tracks how innovations evolve within complex systems and their impact, considering individual and team decisions and sociodemographic networks.
3. Social Logic: Focuses on effectively translating knowledge to improve practices, incorporating participatory action research methods.

The evaluation procedure, guided by a co-design approach, includes critical steps:

1. Formation of a transdisciplinary group comprising users of the evaluated matter.
2. Agreement on desired outcomes and benchmarks.
3. Planning methods for data collection and analysis.
4. Measuring and tracking constructs to measure innovation impact.
5. Crafting targeted strategies for improvement.
6. Dissemination of lessons learned to stakeholders.

PROLIFERATE is an adaptable framework designed to absorb and combine strategies from other methods, but always centring around five non-hierarchical constructs concerning users and end-users’ feedback:

1. Comprehension
2. Emotional Responses
3. Barriers
4. Motivations
5. Optimization Strategies (which can be designed to capture qualitative data on stakeholders' views and perceptions).

The framework utilises a standardised scoring system to gauge the impact of the evaluated matters, which includes the following categories:

• Poor impact
• Average impact
• Good impact
• Excellent impact

The fifth construct (Optimization Strategies) informs this score interpretation.

PROLIFERATE examines health systems at different levels, providing insights into various dimensions of healthcare:

• Micro
• Meso
• Cross-Scale Components
• Macro

Illustrating its adaptability, two ongoing research case examples in Australian healthcare settings demonstrate the framework's practical implementation and effectiveness.

PROLIFERATE's approach prioritises fostering collaboration, investing time and effort to address resistance to change, and co-designing sustainability strategies or de-implementation if necessary. The involvement of non-academic stakeholders throughout the evaluation process is considered an ethical imperative because of its enriching and guiding significance in optimising research processes, interpreting data, and directing targeted dissemination. This inclusive approach ensures that strategies are tailored to meet the distinct requirements of diverse sociodemographic groups, as informed by the collaborative efforts of the transdisciplinary team.

Reference: Pinero de Plaza, M.A., Yadav, L., & Kitson, A. (2023). Co-designing, measuring, and optimizing innovations and solutions within complex adaptive health systems. Frontiers in Health Services, 3, 1154614. doi:10.3389/frhs.2023.1154614. https://doi.org/10.3389/frhs.2023.1154614