TY - JOUR T1 - Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes JF - BMJ Global Health DO - 10.1136/bmjgh-2018-001068 VL - 3 IS - 6 SP - e001068 AU - Josefien van Olmen AU - Peter Delobelle AU - David Guwatudde AU - Pilvikki Absetz AU - David Sanders AU - Helle Mölsted Alvesson AU - Thandi Puoane AU - Claes-Goran Ostenson AU - Göran Tomson AU - Roy William Mayega AU - Carl Johan Sundberg AU - Stefan Peterson AU - Meena Daivadanam Y1 - 2018/11/01 UR - http://gh.bmj.com/content/3/6/e001068.abstract N2 - This paper reports on the use of reciprocal learning for identifying, adopting and adapting a type 2 diabetes self-management support intervention in a multisite implementation trial conducted in a rural setting in a low-income country (Uganda), a periurban township in a middle-income country (South Africa) and socioeconomically disadvantaged suburbs in a high-income country (Sweden). The learning process was guided by a framework for knowledge translation and structured into three learning cycles, allowing for a balance between evidence, stakeholder interaction and contextual adaptation. Key factors included commitment, common goals, leadership and partnerships. Synergistic outcomes were the cocreation of knowledge, interventions and implementation methods, including reverse innovations such as adaption of community-linked models of care. Contextualisation was achieved by cross-site exchanges and local stakeholder interaction to balance intervention fidelity with local adaptation. Interdisciplinary and cross-site collaboration resulted in the establishment of learning networks. Limitations of reciprocal learning relate to the complexity of the process with unpredictable outcomes and the limited generalisability of results. ER -