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Bridging the Gap (BTG) is an audit-and-feedback (AF) intervention aimed at improving both transitions-in-care processes and diabetes management in the year following transition. As part of BTG, we conducted a qualitative process evaluation to understand: (a) what was implemented and how; and (b) the contextual factors (micro-, meso- and macro-) that affected implementation, outcomes and study processes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using qualitative descriptive methodology, interviews were conducted with 13 healthcare professionals (HCPs) delivering diabetes care to transitioning youth. Participants were asked about their experiences of BTG study processes and feedback tools, the quality improvement (QI) initiatives implemented at their site, and potential spread and scale. Interviews also explored the impacts of COVID-19 on transition care and study processes and results.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Five key themes were identified. Participants\u2019 <jats:italic>reflections on the BTG study design<\/jats:italic> indicated they appreciated its flexible, site-specific approach to QI, which they saw as crucial to the success of their initiatives. <jats:italic>Engagement with feedback reports and other study resources<\/jats:italic> provided comparative, site-specific data. Participants described <jats:italic>the challenges posed by the COVID-19 pandemic<\/jats:italic> and its impacts on patients, care provision and study implementation. Their <jats:italic>site-specific QI initiatives<\/jats:italic> resulted in changes to their transition practices. Finally, participants commented on how BTG and its processes <jats:italic>fostered a community of practice (CoP)<\/jats:italic> between sites, resulting in new opportunities to collaborate and share experiences.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>BTG resulted in a CoP among practitioners delivering transition care to youth with T1D, which could be scaled up to promote a learning health system in pediatric diabetes care. Qualitative process evaluation is a useful tool for understanding how contextual factors affect the implementation and outcomes of complex QI interventions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-024-11734-1","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T14:03:58Z","timestamp":1729692238000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes"],"prefix":"10.1186","volume":"24","author":[{"given":"Janet A.","family":"Parsons","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannah","family":"Wigle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Zenlea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Ivers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetha","family":"Mukerji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alanna","family":"Landry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubin","family":"Punthakee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheril L.","family":"Clarson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rayzel","family":"Shulman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"11734_CR1","doi-asserted-by":"publisher","unstructured":"Markowitz B, Parsons JA, Advani A. 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CTO research sites participating in a multi-site research study undergo a single ethics review. The Trillium Health Partners Research Ethics Board also granted ethics approval. All participants provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. All data in this paper have been de-identified.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"RS has received speaking and advisory board fees from Dexcom Canada. IZ reports receiving personal fees from Abbott Diabetes Care, Dexcom, Novo Nordisk Canada Inc., and the Ontario Association of Social Workers, and research funding support from the University of Toronto, Navigator Limited, Medical Psychiatry Alliance, Regional Municipality of Peel, Community Foundation of Mississauga, Canadian Institutes of Health Research. No other potential conflicts of interest relevant to this article were reported by the other authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1276"}}