Summary

Primary care in Canada is in crisis, largely due to workforce shortages that limit timely, equitable, and high-quality care. In response, provinces are pursuing reforms, including team-based models like Family Care Teams (FCTs). The Health Accord Newfoundland and Labrador (HANL) task force developed a 5-year plan to transform the health system, with FCTs as a key recommendation to improve access to comprehensive, longitudinal care.

This project supports the implementation of FCTs by addressing common pitfalls in complex interventions, such as weak stakeholder engagement, unclear program theory, and narrow evaluation frameworks. Using the Medical Research Council’s latest guidance, investigators will co-develop the program theory with interest-holders using a review of peer-reviewed and grey literature, and a process evaluation of ongoing implementation, including a thorough investigation of contextual factors.

We will also map identified barriers to theoretical and evidence-based strategies, and develop a comprehensive evaluation framework to assess if, how, and under what conditions the FCTs achieve intended outcomes.

This project is funded by the CIHR – Strengthening the Health Workforce for System Transformation — Reference #194145.

Objectives

This project aims to inform the implementation, evaluation, and spread of Family Care Teams (FCTs) in NL — understanding how FCTs affect outcomes, including the mediators and moderators of their effects.

Inform FCT implementation across NL
Evaluate outcomes — what works, for whom, and when
Advance implementation science for team-based care
Co-develop program theory with interest-holders
Map barriers to evidence-based strategies
Scale successful FCT models across the province
Watch: Objectives overview A short video walkthrough of the project’s key objectives and aims.
View: Objectives infographic A visual summary of how the project objectives are structured and connected.

Methodology

Guided by the Medical Research Council’s framework for complex interventions, this project uses a phased approach — examining not just what FCTs do, but how context shapes their implementation and outcomes.

1
Literature Review Systematic review to establish program theory and identify mediators of FCT effectiveness.
2
Interest-holder Co-development Collaborative sessions with patients, providers, and knowledge users to shape the evaluation framework.
3
Process Evaluation In-depth investigation of contextual factors, fidelity, reach, and mechanisms of impact.
4
Evaluation Framework Comprehensive framework mapping barriers to evidence-based implementation strategies.
Watch: Methodology overview A short video walkthrough of the project’s four-phase research methodology.
View: Methodology infographic A visual diagram of the MRC-guided methodology and how each phase connects.

Grant Deliverables

The following key outputs are planned or underway as part of this CIHR-funded project.

Program TheoryIn progress
Evaluation FrameworkIn progress
Process EvaluationIn progress
Toolkits & KT ProductsIn progress
Scale & Spread GuidancePlanned

Our Team

PRIIME team photo

Leadership

  • Amanda Hall (NPI)
  • Kris Aubrey-Bassler (Co-PI)
  • Margot Antle (PKU)
  • Darla King (PKU)

Patient Partners

  • Dorothy Senior
  • Jennifer Pike
  • Krystal Pardy
  • Jody Kinden

Researchers

  • Paul Banahene Adjei
  • Boluwaji Ogumyemi
  • Maisam Najafizada
  • Shabnam Asghari
  • Andrea Pike
  • Holly Etchegary
  • Julia Lukewich
  • Andrea Patey
  • Brendan Barrett

Knowledge Users

  • Pat Parfrey
  • Heather Hanrahan
  • Cheryl Etchegary
  • Erin Ballah
  • Trina Ralph
  • Stephen Wan
  • Adam Wylie
  • Deborah Wearn
  • Jamie DeMore