{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:00:13Z","timestamp":1780383613192,"version":"3.54.1"},"reference-count":78,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,10,13]]},"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review how process evaluations are currently designed, what methodologies are used and how are they developed alongside or within neurological rehabilitation trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This mixed-methods systematic review had two evidence streams: stream I, studies reporting process evaluations alongside neurorehabilitation trials research and stream II, methodological guidance on process evaluation design and methodology. A search strategy was designed for each evidence stream. Data regarding process evaluation core concepts and design issues were extracted using a bespoke template. Evidence from both streams was analysed separately and then synthesised in a final overarching synthesis proposing a number of recommendations for future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 124 process evaluation studies, reporting on 106 interventions, were included in stream I evidence. 30 studies were included as stream II evidence. Synthesis 1 produced 9 themes, and synthesis 2 identified a total of 8 recommendations for process evaluation research. The overall synthesis resulted in 57 \u2018synthesis recommendations\u2019 about process evaluation methodology grouped into 9 research areas, including the use of theory, the investigation of context, intervention staff characteristics and the delivery of the trial intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There remains no consensus regarding process evaluation terminology within the neurological rehabilitation field. There is a need for process evaluations to address the nature and influence of context over time. Process evaluations should clearly describe what intervention staff bring to a trial, including skills and experience prior to joining the research. Process evaluations should monitor intervention staff's learning effects and the possible impact that these may have on trial outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013002","type":"journal-article","created":{"date-parts":[[2016,11,9]],"date-time":"2016-11-09T06:47:05Z","timestamp":1478674025000},"page":"e013002","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6344-1346","authenticated-orcid":false,"given":"Patricia","family":"Masterson-Algar","sequence":"first","affiliation":[{"name":"School of Healthcare Sciences, Bangor University, Bangor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R","family":"Burton","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, Bangor University, Bangor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Rycroft-Malone","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, Bangor University, Bangor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,11,8]]},"reference":[{"key":"2025120600531460000_6.11.e013002.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.11.013"},{"key":"2025120600531460000_6.11.e013002.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2011.11.039"},{"key":"2025120600531460000_6.11.e013002.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.03.035"},{"key":"2025120600531460000_6.11.e013002.4","unstructured":"Townsend E . Enabling occupation: an occupational therapy perspective. Ottawa: Canadian Association of Occupational Therapists, 2012."},{"key":"2025120600531460000_6.11.e013002.5","unstructured":"Medical Research Council. Developing and evaluation complex interventions: new guidance. London: Medical Research Council, 2008."},{"key":"2025120600531460000_6.11.e013002.6","doi-asserted-by":"publisher","DOI":"10.1191\/0269215505cr787oa"},{"key":"2025120600531460000_6.11.e013002.7","doi-asserted-by":"publisher","DOI":"10.1159\/000086511"},{"key":"2025120600531460000_6.11.e013002.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000237097.00342.a9"},{"key":"2025120600531460000_6.11.e013002.9","first-page":"413","article-title":"Process evaluation in randomised controlled trials of complex interventions","volume":"332","author":"Oakley","year":"2006","journal-title":"Health Serv Res"},{"key":"2025120600531460000_6.11.e013002.10","unstructured":"Moore G , Audrey S , Barker M , et al . Process evaluation of complex interventions: Medical Research Council guidance. London: MRC Population Health Science Research Network, 2014."},{"key":"2025120600531460000_6.11.e013002.11","unstructured":"Steckler A , Linnan L . Process evaluation for public health interventions and research. San Francisco (CA): Jossey-Bass, 2002."},{"key":"2025120600531460000_6.11.e013002.12","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.12.1.40"},{"key":"2025120600531460000_6.11.e013002.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.333.7563.346"},{"key":"2025120600531460000_6.11.e013002.14","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-8-274"},{"key":"2025120600531460000_6.11.e013002.15","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/1471-2377-10-74","article-title":"Feasibility of a mental practice intervention in stroke patients in nursing homes; a process evaluation","volume":"10","author":"Braun","year":"2010","journal-title":"BMC Neurol"},{"key":"2025120600531460000_6.11.e013002.16","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-14-15"},{"key":"2025120600531460000_6.11.e013002.17","unstructured":"Centre for Reviews and Dissemination. Systematic reviews: CRD's guidance for undertaking reviews in health care. York: University of York, 2009."},{"key":"2025120600531460000_6.11.e013002.18","unstructured":"EPPI-Centre: EPPI-Centre methods for conducting systematic reviews. 2010. http:\/\/eppi.ioe.ac.uk\/cms\/LinkClick.aspx?fileticket=hQBu8y4uVwI%.3d&tabid=88&mid=6162"},{"key":"2025120600531460000_6.11.e013002.19","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2003.014829"},{"key":"2025120600531460000_6.11.e013002.20","doi-asserted-by":"publisher","DOI":"10.1177\/1356389005059383"},{"key":"2025120600531460000_6.11.e013002.21","doi-asserted-by":"publisher","DOI":"10.4278\/0890-1171-21.4.248"},{"key":"2025120600531460000_6.11.e013002.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.10.033"},{"key":"2025120600531460000_6.11.e013002.23","doi-asserted-by":"publisher","DOI":"10.1177\/1524839910390358"},{"key":"2025120600531460000_6.11.e013002.24","unstructured":"Kavanagh J , Trouton A , Oakley A , et al . A systematic review of the evidence for incentive schemes to encourage positive health and other social behaviours in young people. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, 2006."},{"key":"2025120600531460000_6.11.e013002.25","unstructured":"Popay J , Roberts H , Sowden A , et al . Guidance on the conduct of narrative synthesis in systematic reviews: Final report. Swindon: ESRC Methods Programme."},{"key":"2025120600531460000_6.11.e013002.26","unstructured":"Thomas J , Harden A , Newman M . Synthesis: combining results systematically and appropriately. In: Gough D , Oliver S , Thomas J , eds. An introduction to systematic reviews. London: Sage, 2012:179\u2013226."},{"key":"2025120600531460000_6.11.e013002.27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-8-1"},{"key":"2025120600531460000_6.11.e013002.28","first-page":"795294","article-title":"Feasibility, safety, and compliance in a randomized controlled trial of physical therapy for Parkinson's disease","volume":"2012","author":"McGinley","year":"2012","journal-title":"Parkinsons Dis"},{"key":"2025120600531460000_6.11.e013002.29","doi-asserted-by":"publisher","DOI":"10.1002\/art.24115"},{"key":"2025120600531460000_6.11.e013002.30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3233\/TAD-2007-192-303","article-title":"Health economic and process evaluation of AT interventions for persons with dementia and their relatives\u2014a suggested assessment model","volume":"19","author":"Alwin","year":"2007","journal-title":"Technol Disabil"},{"key":"2025120600531460000_6.11.e013002.31","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.3109\/09638288.2012.743603","article-title":"Perception and significance of an assistive technology intervention\u2014the perspectives of relatives of persons with dementia","volume":"35","author":"Alwin","year":"2013","journal-title":"Disabil Rehabil"},{"key":"2025120600531460000_6.11.e013002.32","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20100438"},{"key":"2025120600531460000_6.11.e013002.33","doi-asserted-by":"publisher","DOI":"10.1177\/0269215512473762"},{"key":"2025120600531460000_6.11.e013002.34","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1590\/S1413-35552012000100008","article-title":"Challenges in recruitment, attendance and adherence of acute stroke survivors to a randomized trial in Brazil: a feasibility study","volume":"16","author":"Scianni","year":"2012","journal-title":"Rev Bras Fisioter"},{"key":"2025120600531460000_6.11.e013002.35","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1186\/1472-6963-13-190","article-title":"Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation","volume":"13","author":"Scobbie","year":"2013","journal-title":"BMC Health Serv Res"},{"key":"2025120600531460000_6.11.e013002.36","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-11-13"},{"key":"2025120600531460000_6.11.e013002.37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1300\/J006v18n02_01","article-title":"The evaluation of functional, school-based therapy services for children with special needs: a feasibility study","volume":"18","author":"King","year":"1998","journal-title":"Phys Occup Ther Pediatr"},{"key":"2025120600531460000_6.11.e013002.38","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1471-2318-9-44","article-title":"WHEDA study: effectiveness of occupational therapy at home for older people with dementia and their caregivers\u2014the design of a pragmatic randomised controlled trial evaluating a Dutch programme in seven German centres","volume":"9","author":"Voigt-Radloff","year":"2009","journal-title":"BMC Geriatr"},{"key":"2025120600531460000_6.11.e013002.39","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000094"},{"key":"2025120600531460000_6.11.e013002.40","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2008.00615.x"},{"key":"2025120600531460000_6.11.e013002.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.09.576"},{"key":"2025120600531460000_6.11.e013002.42","doi-asserted-by":"publisher","DOI":"10.1080\/17518420802525500"},{"key":"2025120600531460000_6.11.e013002.43","doi-asserted-by":"publisher","DOI":"10.1177\/0269215513476312"},{"key":"2025120600531460000_6.11.e013002.44","doi-asserted-by":"publisher","DOI":"10.1080\/10400435.2012.715113"},{"key":"2025120600531460000_6.11.e013002.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2006.08.005"},{"key":"2025120600531460000_6.11.e013002.46","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1123\/japa.15.2.139","article-title":"Tai chi-based exercise for older adults with Parkinson's disease: a pilot-program evaluation","volume":"15","author":"Li","year":"2007","journal-title":"J Aging Phys Act"},{"key":"2025120600531460000_6.11.e013002.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2003.09.001"},{"key":"2025120600531460000_6.11.e013002.48","doi-asserted-by":"publisher","DOI":"10.1310\/tsr18s01-611"},{"key":"2025120600531460000_6.11.e013002.49","doi-asserted-by":"publisher","DOI":"10.1002\/gps.2782"},{"key":"2025120600531460000_6.11.e013002.50","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/1748-5908-8-131","article-title":"Determinants for the effectiveness of implementing an occupational therapy intervention in routine dementia care","volume":"8","author":"D\u00f6pp","year":"2013","journal-title":"Implement Sci"},{"key":"2025120600531460000_6.11.e013002.51","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/1472-6963-12-132","article-title":"Comparing Dutch case management care models for people with dementia and their caregivers: the design of the COMPAS study","volume":"12","author":"MacNeil Vroomen","year":"2012","journal-title":"BMC Health Serv Res"},{"key":"2025120600531460000_6.11.e013002.52","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1017\/BrImp.2012.28","article-title":"Acceptance and commitment therapy (ACT) for psychological adjustment after traumatic brain injury: reporting the protocol for a randomised controlled trial","volume":"13","author":"Whiting","year":"2012","journal-title":"Brain Impair"},{"key":"2025120600531460000_6.11.e013002.53","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.73.5.852"},{"key":"2025120600531460000_6.11.e013002.54","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-164"},{"key":"2025120600531460000_6.11.e013002.55","doi-asserted-by":"publisher","DOI":"10.1177\/1524839904273387"},{"key":"2025120600531460000_6.11.e013002.56","doi-asserted-by":"publisher","DOI":"10.1177\/000841749506200506"},{"key":"2025120600531460000_6.11.e013002.57","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-2-40"},{"key":"2025120600531460000_6.11.e013002.58","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(97)00043-3"},{"key":"2025120600531460000_6.11.e013002.59","doi-asserted-by":"publisher","DOI":"10.1093\/her\/18.2.237"},{"key":"2025120600531460000_6.11.e013002.60","unstructured":"Bate P . Context is everything. In: Perspectives on context. Original research. The Health Foundation\u2014inspiring improvement. London: The Health Foundation, 2014:1\u201330."},{"key":"2025120600531460000_6.11.e013002.61","unstructured":"Dixon-Woods M . The problem of context in quality improvement. In: Perspectives on context. Original research. The Health Foundation\u2014inspiring improvement. London: The Health Foundation, 2014:87\u2013101."},{"key":"2025120600531460000_6.11.e013002.62","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39108.379965.BE"},{"key":"2025120600531460000_6.11.e013002.63","doi-asserted-by":"publisher","DOI":"10.1080\/09540120220123739"},{"key":"2025120600531460000_6.11.e013002.64","doi-asserted-by":"publisher","DOI":"10.3310\/hta18520"},{"key":"2025120600531460000_6.11.e013002.65","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(00)00272-5"},{"key":"2025120600531460000_6.11.e013002.66","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-200401000-00010"},{"key":"2025120600531460000_6.11.e013002.67","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6155.2006.00050.x"},{"key":"2025120600531460000_6.11.e013002.68","first-page":"1","article-title":"Assessing the learning curve effect in health technologies. Lessons from the nonclinical literature","volume":"18","author":"Ramsay","year":"2002","journal-title":"Int J Technol Assess Health Care"},{"key":"2025120600531460000_6.11.e013002.69","doi-asserted-by":"publisher","DOI":"10.1191\/1740774504cn042oa"},{"key":"2025120600531460000_6.11.e013002.70","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12174"},{"key":"2025120600531460000_6.11.e013002.71","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462300103149"},{"key":"2025120600531460000_6.11.e013002.72","doi-asserted-by":"publisher","DOI":"10.1023\/B:PREV.0000013980.12412.cd"},{"key":"2025120600531460000_6.11.e013002.73","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2009.21.2.128"},{"key":"2025120600531460000_6.11.e013002.74","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2006.18.supp.184"},{"key":"2025120600531460000_6.11.e013002.75","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1365-2648.2008.04686.x","article-title":"In response to Spillane V., Byrne M. C., Byrne M., Leathem C. S., O'Malley M. & Cupples M. E. (2007) Monitoring treatment fidelity in a randomized trial of a complex intervention. Journal of Advanced Nursing 60(3), 343\u2013352. Important considerations for standardizing complex interventions","volume":"62","author":"Hawe","year":"2008","journal-title":"J Adv Nurs"},{"key":"2025120600531460000_6.11.e013002.76","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2009.05216.x"},{"key":"2025120600531460000_6.11.e013002.77","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c332"},{"key":"2025120600531460000_6.11.e013002.78","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T08:53:27Z","timestamp":1765011207000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":78,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2016,11,8]]},"published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1136\/bmjopen-2016-013002"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013002","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11]]}}}