RT Journal Article SR Electronic 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 FD BMJ Publishing Group Ltd SP e001068 DO 10.1136/bmjgh-2018-001068 VO 3 IS 6 A1 Josefien van Olmen A1 Peter Delobelle A1 David Guwatudde A1 Pilvikki Absetz A1 David Sanders A1 Helle Mölsted Alvesson A1 Thandi Puoane A1 Claes-Goran Ostenson A1 Göran Tomson A1 Roy William Mayega A1 Carl Johan Sundberg A1 Stefan Peterson A1 Meena Daivadanam YR 2018 UL http://gh.bmj.com/content/3/6/e001068.abstract AB 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.