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Implementation Science: IS

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https://www.readbyqxmd.com/read/28651613/an-audience-research-study-to-disseminate-evidence-about-comprehensive-state-mental-health-parity-legislation-to-us-state-policymakers-protocol
#1
Jonathan Purtle, Félice Lê-Scherban, Paul Shattuck, Enola K Proctor, Ross C Brownson
BACKGROUND: A large proportion of the US population has limited access to mental health treatments because insurance providers limit the utilization of mental health services in ways that are more restrictive than for physical health services. Comprehensive state mental health parity legislation (C-SMHPL) is an evidence-based policy intervention that enhances mental health insurance coverage and improves access to care. Implementation of C-SMHPL, however, is limited. State policymakers have the exclusive authority to implement C-SMHPL, but sparse guidance exists to inform the design of strategies to disseminate evidence about C-SMHPL, and more broadly, evidence-based treatments and mental illness, to this audience...
June 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28651602/rapid-sociometric-mapping-of-community-health-workers-to-identify-opinion-leaders-using-an-sms-platform-a-short-report
#2
Thomas A Odeny, Maya Petersen, Charles T Muga, Jayne Lewis-Kulzer, Elizabeth A Bukusi, Elvin H Geng
BACKGROUND: Using opinion leaders to accelerate the dissemination of evidence-based public health practices is a promising strategy for closing the gap between evidence and practice. Network interventions (using social network data to accelerate behavior change or improve organizational performance) are a promising but under-explored strategy. We aimed to use mobile phone technology to rapidly and inexpensively map a social network and identify opinion leaders among community health workers in a large HIV program in western Kenya...
June 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28646886/implementation-science-for-ambulatory-care-safety-a-novel-method-to-develop-context-sensitive-interventions-to-reduce-quality-gaps-in-monitoring-high-risk-patients
#3
Kathryn M McDonald, George Su, Sarah Lisker, Emily S Patterson, Urmimala Sarkar
BACKGROUND: Missed evidence-based monitoring in high-risk conditions (e.g., cancer) leads to delayed diagnosis. Current technological solutions fail to close this safety gap. In response, we aim to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality. METHODS: Based on interviews with staff in otolaryngology, pulmonary, urology, breast, and gastroenterology clinics at a large urban publicly funded health system, we applied journey mapping to co-develop a visual representation of how patients are monitored for high-risk conditions...
June 24, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28645319/architectural-frameworks-defining-the-structures-for-implementing-learning-health-systems
#4
Lysanne Lessard, Wojtek Michalowski, Michael Fung-Kee-Fung, Lori Jones, Agnes Grudniewicz
BACKGROUND: The vision of transforming health systems into learning health systems (LHSs) that rapidly and continuously transform knowledge into improved health outcomes at lower cost is generating increased interest in government agencies, health organizations, and health research communities. While existing initiatives demonstrate that different approaches can succeed in making the LHS vision a reality, they are too varied in their goals, focus, and scale to be reproduced without undue effort...
June 23, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28637486/a-guide-to-using-the-theoretical-domains-framework-of-behaviour-change-to-investigate-implementation-problems
#5
Lou Atkins, Jill Francis, Rafat Islam, Denise O'Connor, Andrea Patey, Noah Ivers, Robbie Foy, Eilidh M Duncan, Heather Colquhoun, Jeremy M Grimshaw, Rebecca Lawton, Susan Michie
BACKGROUND: Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour...
June 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28637479/pediatric-emental-healthcare-technologies-a-systematic-review-of-implementation-foci-in-research-studies-and-government-and-organizational-documents
#6
REVIEW
Nicole D Gehring, Patrick McGrath, Lori Wozney, Amir Soleimani, Kathryn Bennett, Lisa Hartling, Anna Huguet, Michele P Dyson, Amanda S Newton
BACKGROUND: Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. METHODS: A search of eleven electronic databases and grey literature was conducted...
June 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28610574/predicting-evidence-based-treatment-sustainment-results-from-a-longitudinal-study-of-the-adolescent-community-reinforcement-approach
#7
Sarah B Hunter, Bing Han, Mary E Slaughter, Susan H Godley, Bryan R Garner
BACKGROUND: Implementation support models are increasingly being used to enhance the delivery of evidence-based treatments (EBTs) in routine care settings. Little is known about the extent to which these models lead to continued EBT use after implementation support ends. Moreover, few empirical studies longitudinally examine the hypothesized factors associated with long-term psychosocial EBT use (i.e., sustainment). In an effort to address this gap, the current study examined sustainment of an EBT called the Adolescent-Community Reinforcement Approach (A-CRA) following the end of implementation support...
June 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28583164/health-professionals-views-on-the-barriers-and-enablers-to-evidence-based-practice-for-acute-stroke-care-a-systematic-review
#8
REVIEW
Leonard Baatiema, Michael E Otim, George Mnatzaganian, Ama de-Graft Aikins, Judith Coombes, Shawn Somerset
BACKGROUND: Adoption of contemporary evidence-based guidelines for acute stroke management is often delayed due to a range of key enablers and barriers. Recent reviews on such barriers focus mainly on specific acute stroke therapies or generalised stroke care guidelines. This review examined the overall barriers and enablers, as perceived by health professionals which affect how evidence-based practice guidelines (stroke unit care, thrombolysis administration, aspirin usage and decompressive surgery) for acute stroke care are adopted in hospital settings...
June 5, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28576148/the-creation-and-validation-of-the-measure-of-effective-attributes-of-trainers-meat
#9
Meredith R Boyd, Cara C Lewis, Kelli Scott, Anne Krendl, Aaron R Lyon
BACKGROUND: Training is a core component in the implementation of empirically supported treatments, especially in the case of psychosocial interventions targeting mental illness. However, common forms of training are relatively ineffective in producing behavioral changes in providers. Trainers are in a strategic position to influence the success of training, but no research, to our knowledge, has explored whether personal characteristics of trainers (e.g., enthusiasm, charisma) increase effectiveness of training empirically supported treatments in the field of mental health...
June 2, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28558843/the-effectiveness-of-a-de-implementation-strategy-to-reduce-low-value-blood-management-techniques-in-primary-hip-and-knee-arthroplasty-a-pragmatic-cluster-randomized-controlled-trial
#10
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Stefanie N Hofstede, Cynthia So-Osman, M Elske van den Akker-van Marle, Ad A Kaptein, Theo Stijnen, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
BACKGROUND: Perioperative autologous blood salvage and preoperative erythropoietin are not (cost) effective to reduce allogeneic transfusion in primary hip and knee arthroplasty, but are still used. This study aimed to evaluate the effectiveness of a theoretically informed multifaceted strategy to de-implement these low-value blood management techniques. METHODS: Twenty-one Dutch hospitals participated in this pragmatic cluster-randomized trial. At baseline, data were gathered for 924 patients from 10 intervention and 1040 patients from 11 control hospitals undergoing hip or knee arthroplasty...
May 30, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28549480/improving-the-appropriateness-of-antipsychotic-prescribing-in-nursing-homes-a-mixed-methods-process-evaluation-of-an-academic-detailing-intervention
#11
L Desveaux, M Saragosa, J Rogers, L Bevan, H Loshak, A Moser, S Feldman, L Regier, L Jeffs, N M Ivers
BACKGROUND: In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appropriate prescribing of APM in nursing homes in a cluster-randomized trial. This mixed-methods study aimed to explore how and why the AD intervention may have resulted in changes in the nursing home context...
May 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#12
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545535/electronic-audit-and-feedback-intervention-with-action-implementation-toolbox-to-improve-pain-management-in-intensive-care-protocol-for-a-laboratory-experiment-and-cluster-randomised-trial
#13
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Evert de Jonge, Niels Peek, Dave A Dongelmans, Nicolette F de Keizer
BACKGROUND: Audit and feedback is often used as a strategy to improve quality of care, however, its effects are variable and often marginal. In order to learn how to design and deliver effective feedback, we need to understand their mechanisms of action. This theory-informed study will investigate how electronic audit and feedback affects improvement intentions (i.e. information-intention gap), and whether an action implementation toolbox with suggested actions and materials helps translating those intentions into action (i...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545492/non-participants-in-policy-efforts-to-promote-evidence-based-practices-in-a-large-behavioral-health-system
#14
Rebecca E Stewart, Danielle R Adams, David S Mandell, Gayatri Nangia, Lauren Shaffer, Arthur C Evans, Ronnie Rubin, Shawna Weaver, Trevor R Hadley, Rinad S Beidas
BACKGROUND: System-wide training initiatives to support and implement evidence-based practices (EBPs) in behavioral health systems have become increasingly widespread. Understanding more about organizations who do not participate in EBP training initiatives is a critical piece of the dissemination and implementation puzzle if we endeavor to increase access in community settings. METHODS: We conducted 30 1-h semi-structured interviews with leaders in non-participating agencies who did not formally participate in system-wide training initiatives to implement EBPs in the City of Philadelphia, with the goal to understand why they did not participate...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28526041/implementation-of-enhanced-recovery-after-surgery-a-strategy-to-transform-surgical-care-across-a-health-system
#15
Leah M Gramlich, Caroline E Sheppard, Tracy Wasylak, Loreen E Gilmour, Olle Ljungqvist, Carlota Basualdo-Hammond, Gregg Nelson
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system...
May 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28521782/combining-alcohol-interventions-with-tobacco-addictions-treatment-in-primary-care-the-combat-study-a-pragmatic-cluster-randomized-trial
#16
Nadia Minian, Dolly Baliunas, Laurie Zawertailo, Aliya Noormohamed, Norman Giesbrecht, Christian S Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
BACKGROUND: Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28521750/data-for-improvement-and-clinical-excellence-a-report-of-an-interrupted-time-series-trial-of-feedback-in-home-care
#17
Kimberly D Fraser, Anne E Sales, Melba Andrea B Baylon, Corinne Schalm, John J Miklavcic
BACKGROUND: There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28499408/organizational-theory-for-dissemination-and-implementation-research
#18
Sarah A Birken, Alicia C Bunger, Byron J Powell, Kea Turner, Alecia S Clary, Stacey L Klaman, Yan Yu, Daniel J Whitaker, Shannon R Self, Whitney L Rostad, Jenelle R Shanley Chatham, M Alexis Kirk, Christopher M Shea, Emily Haines, Bryan J Weiner
BACKGROUND: Even under optimal internal organizational conditions, implementation can be undermined by changes in organizations' external environments, such as fluctuations in funding, adjustments in contracting practices, new technology, new legislation, changes in clinical practice guidelines and recommendations, or other environmental shifts. Internal organizational conditions are increasingly reflected in implementation frameworks, but nuanced explanations of how organizations' external environments influence implementation success are lacking in implementation research...
May 12, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28499401/are-general-and-strategic-measures-of-organizational-context-and-leadership-associated-with-knowledge-and-attitudes-toward-evidence-based-practices-in-public-behavioral-health-settings-a-cross-sectional-observational-study
#19
Byron J Powell, David S Mandell, Trevor R Hadley, Ronnie M Rubin, Arthur C Evans, Matthew O Hurford, Rinad S Beidas
BACKGROUND: Examining the role of modifiable barriers and facilitators is a necessary step toward developing effective implementation strategies. This study examines whether both general (organizational culture, organizational climate, and transformational leadership) and strategic (implementation climate and implementation leadership) organizational-level factors predict therapist-level determinants of implementation (knowledge of and attitudes toward evidence-based practices). METHODS: Within the context of a system-wide effort to increase the use of evidence-based practices (EBPs) and recovery-oriented care, we conducted an observational, cross-sectional study of 19 child-serving agencies in the City of Philadelphia, including 23 sites, 130 therapists, 36 supervisors, and 22 executive administrators...
May 12, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28499393/reversing-the-pipeline-implementing-public-health-evidence-based-guidance-in-english-local-government
#20
Lou Atkins, Michael P Kelly, Clare Littleford, Gillian Leng, Susan Michie
BACKGROUND: In the UK, responsibility for many public health functions was transferred in 2013 from the National Health Service (NHS) to local government; a very different political context and one without the NHS history of policy and practice being informed by evidence-based guidelines. A problem this move presented was whether evidence-based guidelines would be seen as relevant, useful and implementable within local government. This study investigates three aspects of implementing national evidence-based recommendations for public health within a local government context: influences on implementation, how useful guidelines are perceived to be and whether the linear evidence-guidelines-practice model is considered relevant...
May 12, 2017: Implementation Science: IS
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