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Table 1 Coding Scheme for Indigenous Implementation Framework

From: Implementation framework for chronic disease intervention effectiveness in Māori and other indigenous communities

Variable/Definition High Medium Low Negative
Community voice: Community part of defining problem and identifying solutions. Community is group or groups that the intervention is focussed on. Community involved in defining the problem and developing the solution Community involved in either defining the problem or developing the solution. OR multiple communities involved but only one community involved in problem definition and solution development. Community only informed or gives implicit approval but has no direct involvement in the definition of problem or solution development. Intervention implemented in the face of significant community opposition
Reflexivity: Questioning the unstated and taken-for-granted power and privilege from which outsiders initiate contact with the community. The implementation team explicitly states their reflexivity and identifies adjustments to the intervention as a result. The implementation team identifies efforts to engage in reflexivity or states they were aware of it; adjustments to the intervention are unclear. No evidence that the team was reflexive about its processes or, no changes made in response to team learning’s. Victim blaming, unintended bias or overt racism in intervention design, implementation or evaluation.
Structural transformation and resources: Changing the nature of the system to better fit the community needs. Significant structural transformation and resources which are sustainable over time. Structural transformation and resources that are minimal or sustainable over the short term only. Structural transformation and resources that are minimal and sustainable over the short term only. Less resources available or lower quality resources as a result of the intervention compared with no intervention.
Community Engagement: The level of involvement, impact, trust and communication with community members Strong community or bi-direction leadership. Decision making and communication is shared and a strong partnership is identified throughout the intervention process. Communication is bidirectional and the community participates with the intervention team on the issues. Communication is two-way and there is cooperation to implement the intervention with a partnership becoming apparent. Intervention is placed in the community with consultation. Communication primarily flows from intervention team to communition and the intervention team has ultimate control over the intervention and relavent communication. N/A
Integrated Knowledge Translation: How the intervention is implemented with regard to the degree that the knowledge users are equal partners with the intervention team There is a process of mutual or bi-directional learning established so that information is tailored to knowledge users needs. Medium level support for knowledge user by intervention team for implementing the intervention. Intervention is not tailored to the knowledge user. Minimal or no support for implementing intervention or outsiders implement the intervention for the knowledge users. Knowledge users have major concerns about the intervention which they communicate to the intervention team, but they are not able to discuss their concerns with the intervention team.
System perspectives: The degree to which the team demonstrate recognition that there are multiple ways of viewing issues and solutions depending on worldviews, values and interests. Intervention includes all three of the following: 1) multiple causes, 2) broad focus/multiple solutions; and 3) multiple perspectives, worldviews, and values of multiple actors in the system. Intervention includes only on 2 of the 3 factors in high category. Intervention includes 1 or none of the three factors in high category. Intervention has a negative impact on other areas that will result in increasing the problem and issue would have been apparent had team explored multiple perspectives.
System relationships: Prioritises an understanding of relationships between variables/factors rather than taking a laundry list approach Demonstrates strong understanding of the complex relationships between variables including feedback loops, time delays and multi-level effects. Demonstrates moderate understanding of the complex relationships between variables including feedback loops, time delays and multi-level effects. Limited or weak understanding of the complex relationships between variables including feedback loops, time delays and multi-level effects. N/A
System levels: Takes different levels of analysis into account and provides clear rationale for the choices of levels. The intervention targets change at the macro, meso and micro levels, and provides sufficient rationale and context for each level. The intervention targets change at the three levels but does not provide rationale and context for each level. Or, the intervention targets two levels and provides rationale and context. The intervention targets change at two levels or less without providing rationale and context. N/A