Title
Engaging key interest groups to SuStain complEx iNterventions in long-term CarE homes (ESSENCE)

Project Management
Franziska Zúñiga

Co-Project Management
Ruth Melo

INS-Team
Franziska Zúñiga
Flaka Siqeca
Natalie Zimmermann
Lisa Kästner

External partners
University of São Paulo, Brasilien (Ruth Melo, Suzanne Tanoue, Ana Paula Cabrera Parra Bortoluzzi, Paulo Villas-Boas, Meire Cachioni)

Location of Data Selection
Kantone Basel-Stadt, Basel-Landschaft, Aargau, Zürich, Schweiz
São Paulo, Brasilien

Duration
2026 until 2029

Description
Background
Many complex interventions in healthcare show positive effects in the short term, but lose their impact or are abandoned altogether once project funding ends. The sustainability of interventions has so far been studied far less frequently in implementation research than their initial adoption. Long-term care facilities in particular face specific challenges such as staff shortages, financial constraints, and complex organizational structures. To date, there is little practical guidance on how interventions can be sustainably embedded in this setting, especially when comparing countries with different care systems.

Objective
ESSENCE aims to develop, implement, and evaluate context-sensitive implementation strategies for the sustainability of complex interventions in long-term care facilities, comparing German-speaking Switzerland and the state of São Paulo (Brazil). The long-term care facilities themselves are involved as active partners in a co-creation process.

Methods/Design
The project is structured into four work packages (WP1–WP4), embedded within an overarching work package (WP0) that covers the establishment of the working group and spans the entire project duration: 

• WP1: Assessment of the sustainability potential of self-selected interventions using quantitative (Program Sustainability Assessment Tool) and qualitative methods (focus groups on barriers/facilitators)
• WP2: Co-design of context-specific implementation strategies using the Implementation Mapping approach (workshops with the long-term care facilities)
• WP3: Monitoring of implementation and examination of fidelity and adaptations using the FRAME/FRAME-IS models (group online meetings and individual online interviews with the long-term care facilities)
• WP4: Synthesis of results into a practice-oriented sustainability toolkit (including via the World Café method)

In both countries, 3–6 long-term care facilities will be included as partners in the co-creation process.

Expected Benefit/Relevance
ESSENCE addresses an important research gap by going beyond mere implementation and focusing on the transition to sustainable care that is integrated into everyday practice. The cross-country comparison between two different care systems allows for a deeper understanding of how regulatory and cultural contexts influence sustainability. The results will feed into a practice-oriented toolkit that provides long-term care facilities with concrete guidance for the sustainable anchoring of interventions, offering direct benefits for both residents and care staff.