Table 3 Summary of how CoCoPOPP’s design aligned with the PARIHS Framework

Sub-domains

PARIHS definition

CoCoPOPP application

Scientific Research

Evidence needs to be translated and adapted to make sense in the local context. Research evidence is less specific and less value-free than is often acknowledged.

The intervention’s design was scientifically robust as it relied on the research of published sources and matched professional opinions reached by the design group.

Clinical Experience

The tacit knowledge of practitioners, or ‘practical know-how’, must be explicit for practitioner expertise to be shared, critiqued, and developed.

CoCoPOPP’s design team relied on the expert opinions and experiences of professionals. Physicians and clinical practitioners from GHS—PHVHD, TBCC, and TBCHPS—who understand the socio-cultural dynamics, disease prevalence, demographics, health care needs, and services utilization of the communities were part of the design team.

Patient Experience

Inclusion of groups and communities in decision-making.

The intervention’s design included the formation of a COVID-19 committee comprising community leaders and members who can make and influence decisions concerning its implementation.

Local Information

Data on the local context, such as evaluation data, local community stories and knowledge of the organizational culture, must be considered.

The design team considered community perspectives and routine information derived from the members of the communities.

Sub-domains

PARIHS definition

CoCoPOPP application

Culture

Intervention is designed to meet the cultural dynamics of the communities

During CoCoPOPP’s design, the design team gave a significant mandate to the Chief and elders (who are the custodians of the communities) by seeking their approval before the intervention was unveiled for implementation.

Leadership Roles

Clear roles and objectives among stakeholders

Clearly defined roles, responsibilities, objectives, and effective coordination specified for each of the stakeholders and among the various team units

Evaluation

Robust monitoring and evaluation structures

Interdisciplinary investigators from Yale University, Vanderbilt University, University of Ghana, MoH, GHS, and Cocoa360 were noted as participants in CoCoPOPP’s monitoring and evaluation efforts.

The intervention package further allowed for data collection before, during, and after implementation to measure the effectiveness of all possible activities and outcomes.

The intervention design also factored in all the necessary metrics to estimate the possible individual and team performance, activities, outputs, outcomes, and impact of the intervention.

Sub-domains

PARIHS definition

CoCoPOPP application

Characteristics of facilitators

openness, credible, authentic

The village chief and elders are the opinion leaders of the local communities.

The communities recognize as highly credible, respected sources of influence (via authority, status, and representativeness).

Roles of facilitators

clarity of role, authority

To ensure consistency, the facilitators had clearly defined roles to achieve a specific objective in CoCoPOPP’s design and implementation.

Facilitation style

range and flexibility of style, consistent and appropriate presence

Facilitators, especially those directly involved in the intervention’s success, had the experience of at least two years in the environment of the intervention area and were fully aware of the possible challenges they were likely to face.

Hence, they were flexible, showed empathy when dealing with people, and were tenacious in overcoming challenges.