Marie-Claude Tremblay, PhD

1. One program, three modalities of implementation: Analyzing the adaptability of a professional development program in health promotion Marie-Claude Tremblay, PhD Lucie Richard, Sara Torres, Nicole Beaudet, Eric Litvak, François Chiocchio, Julie Des Lauriers

2. Context Professional development = a key component of an effective public health infrastructure. Professional development programs need to be adapted to different and complex real-world practice settings while preserving the core components of the model being used. This is articulating the interplay between fidelityand adaptability to a specific context.

3. Objectives This communication aims to present how a public health professional development program, the Health Promotion Laboratory, has been adapted in three different practice settings while preserving its core nature.

4. Intervention: the Health Promotion Laboratory In 2009, a team from the public health directorate for Montreal (PHDM, Québec) launched an innovative professional development program, the Health Promotion Laboratory. This intervention aims to support, innovatively and flexibly, multidisciplinary local health centre (CSSS) teams working on particular issues (themes), so that they can design and implement a specific health promotion intervention.

5. Intervention: the Health Promotion Laboratory Each HPL is based on a target issue or theme, which is chosen by the participating CSSS. Each team = approximately ten voluntarily participants. HPL = Lenghty process involving three-hour meetings every two or three weeks (for two or three years). Meetings are led by one participant, supported by a mentor from the program promoter agency (PHDM).

6. Intervention: the Health Promotion Laboratory

7. Intervention: the Health Promotion Laboratory The steps of the operational approach = the program’s core components (which refer to the program’s theory). How core components are implemented (format and number of activities, sequence of implementation) = the adaptive part of the program.

8. Methods This implementation analysis is part of a larger multiple case study evaluating the implementation, processes, and outcomes of the Health Promotion Laboratory (Richard et al., 2014). This study involves three sites (A, B and C) and uses documentary sources of data.

9. The cases

10. Data analysis

11. Results Findings highlight that, owing to their particular contexts, all sites developed a unique and adapted approach to implement differently the core components of the program.

12. Table 1. Percentage of activities devoted to each step

13. Figure 1. Pattern of implementation- Lab A

14. Figure 2. Pattern of implementation - Lab B

15. Figure 3. Pattern of implementation– LabC

16. Discussion • The findings presented here show that a health promotion professional development program can be successfully tailored to different settingswithout compromising its core components. • HPL Program allows for : • (1) an initial pre-formatting to accommodate organizational context (theme chosen, team composition, HPL formula); • (2) an ongoing adaptation of implementation to take into account the needs of the participants (nature and number of the activities, patterns of implementation in time)

17. Conclusion This work highlights the need to make explicit the core elements of a program theory that are critical to achieving the program’s intended outcomes. It also illustrates the importance of providing flexibility in a program’s design, such that it can be adapted beforehand to different contexts and then on the ground as the implementation unfolds.

18. Thankyou! • For more information on thisproject, please contact Marie-Claude Tremblay: Marie-Claude.Tremblay3@mcgill.ca (researchassociate) Lucie Richard : lucie.richard@umontreal.ca (ALPS principal investigator) Nicole Beaudet : nbeaudet@santepub-mtl.qc.ca (project manager)