Table 1

Overview of the SETTING-tool, explanation of the content and rationale for each step

STEPContentRationale
1: Coset study prioritiesDefine end-users of the study data, identify other stakeholders, and actively engage all. Then explore the needs and coformulate the exact aim and scope of the context assessment—guided by a theoretical framework, the setting and other priorities.Identifying and engaging stakeholders from the beginning enables that the study meets the stakeholders’ needs, which can be crucial in fostering uptake of the findings into practice later.3 7 22–25
A theoretical framework helps to guide the specification of the aim and methodological orientation.26–29
Implementation research generally aims to produce knowledge applicable across various settings.24
2: Cocreate a mixed-method study design: combine a rapid assessment with a surveyCocreate the mixed-method study design. Include (1) a qualitative rapid assessment process (RAP) in which data are collected by multiple methods, sources and researchers, and 2) a quantitative survey. Triangulate all findings.
A RAP: The key principles of a RAP are (1) a system (community) perspective, (2) rapid, in-depth and iterative data collection and analysis, and (3) triangulation of data. The RAP research team immerses into a community for a short period and collects data simultaneously in subgroups using multiple methods.
Whereas the researchers can provide input on the use of evidence-based methods and a theoretical framework,26 27 the end-users and other stakeholders can provide input on the compatibility of these methods with the local context. This collaboration furthermore stimulates the stakeholders’ engagement.3 7
Mixed-method designs generally provide a better understanding of situations than qualitative or quantitative research alone.3 32
Triangulation of findings optimises validity of research results.34
With a RAP, data collection is highly flexible and driven by local needs.33 35
3: Create context-sensitive study materials with high validityUse evidence-based components where available throughout every substep, in our case: use (1) a theoretical framework, (2) a syndromic approach, (3) a vignette, (4) validated questionnaires, (5) a careful translation process (including translation, back-translation and according adjustments) and (6) pilot-testing of the materials.The framework helps to theoretically underpin material development.26–29
A syndromic (symptom-based) approach helps the participants to identify with the phenomenon studied, when a low awareness about it is expected.
Use of a vignette can help to discuss topics more openly, while avoiding stigmatisation or while addressing sensitive topics.39
4: Collect data with a trained, diverse team including community researchersSet up a diverse team, with local (community) researchers with an insiders’ perspective combined with researchers with an external perspective.
Train the team members by an experienced researcher.
Diversity in the team helps to enlighten the research topic from multiple perspectives and enrich the data.35
The right community researchers are trusted by their community and have a thorough understanding of local networks and local health beliefs and behaviours. The combination with the ‘outsiders’ perspectives’ helps to point out remarkable, typical local themes taken for granted by the community team members.
Training secures ethical standards during data collection and enhances uniformity and high-quality data collection.26
5: Analyse data pragmatically and/or in-depthDecide to analyse the data pragmatically and/or in-depth, depending on the objective.Ensure to timely inform the implementation design for related health interventions, which may have to be supplemented by more in-depth analyses for scientific purposes. For feasibility, findings from pragmatic analyses via a ‘targeted approach’ can also be effective.27
6: Disseminate findings and promote data use (continuous step)Continuously communicate relevant findings to the end-users and other stakeholders using a tailored message and delivery strategy.Frequent communication with end-users and other stakeholders promotes sustained engagement and alignment, and uptake of the findings.7 23 47 48
A systematic, practical tool designed to effectively communicate research findings can guide in facilitating knowledge uptake by policy-makers.23
A tailored message and delivery strategy benefit information use.23 49
  • SETTING-tool, Setting-Exploration-Treasure-Trail-to-Inform-implementatioN-strateGies-tool.