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Implementation Science: IS

Jennifer Leeman, Jean L Wiecha, Maihan Vu, Jonathan L Blitstein, Sallie Allgood, Sarah Lee, Caitlin Merlo
BACKGROUND: The U.S. Centers for Disease Control and Prevention (CDC) develops tools to support implementation of evidence-based interventions for school health. To advance understanding of factors influencing the use of these implementation tools, we conducted an evaluation of state, school district, and local school staffs' use of four CDC tools to support implementation of physical activity, nutrition, health education, and parent engagement. Two frameworks guided the evaluation: Interactive Systems Framework (ISF) for Dissemination and Implementation and Consolidated Framework for Implementation Research (CFIR)...
March 20, 2018: Implementation Science: IS
Anna Köchling, Christin Löffler, Stefan Reinsch, Anne Hornung, Femke Böhmer, Attila Altiner, Jean-François Chenot
BACKGROUND: Although most respiratory tract infections (RTIs) are due to viral infections, they cause the majority of antibiotic (Abx) prescriptions in primary care. This systematic review summarises the evidence on the effectiveness of interventions in primary care aiming to reduce Abx prescriptions in patients ≥ 13 years for acute RTI. METHODS: We searched the databases "MEDLINE/PubMed" and "Cochrane Library" for the period from January 1, 2005, to August 31, 2016, for randomised controlled trials (RCTs) in primary care aiming at the reduction of Abx prescriptions for patients suffering from RTI...
March 20, 2018: Implementation Science: IS
Jane M Garbutt, Sherry Dodd, Emily Walling, Amanda A Lee, Katharine Kulka, Rebecca Lobb
BACKGROUND: The national guideline for use of the vaccine targeting oncogenic strains of the human papillomavirus (HPV) is an evidence-based practice that is poorly implemented in primary care. Recommendations include completion of the vaccine series before the 13th birthday for girls and boys, giving the first dose at the 11- to 12-year-old check-up visit, concurrent with other recommended vaccines. Interventions to increase implementation of this guideline have had little impact, and opportunities to prevent cancer continue to be missed...
March 13, 2018: Implementation Science: IS
Adriana Rodriguez, Anna S Lau, Blanche Wright, Jennifer Regan, Lauren Brookman-Frazee
BACKGROUND: Understanding program leader perspectives on the sustainment of evidence-based practice (EBP) in community mental health settings is essential to improving implementation. To date, however, much of the literature has focused on direct service provider perspectives on EBP implementation. The aim of this mixed-method study was to identify factors associated with the sustainment of multiple EBPs within a system-driven implementation effort in children's mental health services...
March 13, 2018: Implementation Science: IS
Bernadette Brown, Jane Young, David P Smith, Andrew B Kneebone, Andrew J Brooks, Sam Egger, Miranda Xhilaga, Amanda Dominello, Dianne L O'Connell, Mary Haines
BACKGROUND: This study assessed whether a theoretically conceptualised tailored intervention centred on multidisciplinary teams (MDTs) increased clinician referral behaviours in line with clinical practice guideline recommendations. METHODS: Nine hospital Sites in New South Wales (NSW), Australia with a urological MDT and involvement in a state-wide urological clinical network participated in this pragmatic stepped wedge, cluster randomised implementation trial...
March 12, 2018: Implementation Science: IS
Hopin Lee, Alix Hall, Nicole Nathan, Kathryn L Reilly, Kirsty Seward, Christopher M Williams, Serene Yoong, Meghan Finch, John Wiggers, Luke Wolfenden
BACKGROUND: The World Health Organization recommends that nations implement evidence-based nutritional guidelines and policies in settings such as schools and childcare services to improve public health nutrition. Understanding the causal mechanism by which implementation strategies exert their effects could enhance guideline implementation. The aim of this study was to assess the mechanisms by which implementation strategies improved schools and childcare services' adherence to nutrition guidelines...
March 12, 2018: Implementation Science: IS
Jacqueline E Alcalde-Rabanal, Victor M Becerril-Montekio, Etienne V Langlois
No abstract text is available yet for this article.
March 12, 2018: Implementation Science: IS
Isabelle Scholl, Allison LaRussa, Pola Hahlweg, Sarah Kobrin, Glyn Elwyn
BACKGROUND: Shared decision-making (SDM) is poorly implemented in routine care, despite being promoted by health policies. No reviews have solely focused on an in-depth synthesis of the literature around organizational- and system-level characteristics (i.e., characteristics of healthcare organizations and of healthcare systems) that may affect SDM implementation. A synthesis would allow exploration of interventions to address these characteristics. The study aim was to compile a comprehensive overview of organizational- and system-level characteristics that are likely to influence the implementation of SDM, and to describe strategies to address those characteristics described in the literature...
March 9, 2018: Implementation Science: IS
Sara Fokdal Lehn, Jette Thuesen, Gitte Bunkenborg, Ann-Dorthe Zwisler, Morten Hulvej Rod
BACKGROUND: Numerous studies emphasize the importance of context in implementation. Successful implementation across the health care system depends on conditions and requirements that are often presented to health professionals through text-based materials and might present contradictory expectations to the work of health professionals. In this study, we operationalize institutional context as the text-based material, which from the perspective of health professionals, influence health care work...
March 1, 2018: Implementation Science: IS
Emma E McGinty, Elizabeth A Stuart, G Caleb Alexander, Colleen L Barry, Mark C Bicket, Lainie Rutkow
BACKGROUND: The U.S. opioid epidemic has been driven by the high volume of opioids prescribed by healthcare providers. U.S. states have recently enacted four types of laws designed to curb high-risk prescribing practices, such as high-dose and long-term opioid prescribing, associated with opioid-related mortality: (1) mandatory Prescription Drug Monitoring Program (PDMP) enrollment laws, which require prescribers to enroll in their state's PDMP, an electronic database of patients' controlled substance prescriptions, (2) mandatory PDMP query laws, which require prescribers to query the PDMP prior to prescribing an opioid, (3) opioid prescribing cap laws, which limit the dose and/or duration of opioid prescriptions, and (4) pill mill laws, which strictly regulate pain clinics to prevent nonmedical opioid prescribing...
February 26, 2018: Implementation Science: IS
Liesbeth Geerligs, Nicole M Rankin, Heather L Shepherd, Phyllis Butow
BACKGROUND: Translation of evidence-based interventions into hospital systems can provide immediate and substantial benefits to patient care and outcomes, but successful implementation is often not achieved. Existing literature describes a range of barriers and facilitators to the implementation process. This systematic review identifies and explores relationships between these barriers and facilitators to highlight key domains that need to be addressed by researchers and clinicians seeking to implement hospital-based, patient-focused interventions...
February 23, 2018: Implementation Science: IS
Michael J Mello, Sara J Becker, Julie Bromberg, Janette Baird, Mark R Zonfrillo, Anthony Spirito
BACKGROUND: The American College of Surgeons mandates universal screening for alcohol misuse and delivery of an intervention for those screening positive as a requirement for certification as a level 1 trauma center. Though this requirement has been mandated for over a decade, its implementation has been challenging. Our research team completed an implementation study supporting seven pediatric trauma centers' compliance with the requirement by developing and implementing an institutional alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) policy for adolescent trauma patients...
February 22, 2018: Implementation Science: IS
Caitlin G Allen, Brittany Andersen, David A Chambers, Jacob Groshek, Megan C Roberts
BACKGROUND: Poor dissemination of research findings may hamper the reach and impact of scientific discoveries. One key emerging platform for research dissemination is social media, including Twitter. While Twitter and other social media are increasingly being used to disseminate research content presented during scientific conferences, few studies have investigated the extent to which these tools are used throughout conferences and how they are being used. The aim for this study was to better understand the use of Twitter during the 2016 Annual Conference on the Science of Dissemination and Implementation in Health (D&I conference)...
February 20, 2018: Implementation Science: IS
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Dave A Dongelmans, Evert de Jonge, Jill J Francis, Niels Peek, Nicolette F de Keizer
BACKGROUND: Audit and feedback aims to guide health professionals in improving aspects of their practice that need it most. Evidence suggests that feedback fails to increase accuracy of professional perceptions about clinical performance, which likely reduces audit and feedback effectiveness. This study investigates health professionals' perceptions about their clinical performance and the influence of feedback on their intentions to change practice. METHODS: We conducted an online laboratory experiment guided by Control Theory with 72 intensive care professionals from 21 units...
February 17, 2018: Implementation Science: IS
Liz Glidewell, Thomas A Willis, Duncan Petty, Rebecca Lawton, Rosemary R C McEachan, Emma Ingleson, Peter Heudtlass, Andrew Davies, Tony Jamieson, Cheryl Hunter, Suzanne Hartley, Kara Gray-Burrows, Susan Clamp, Paul Carder, Sarah Alderson, Amanda J Farrin, Robbie Foy
BACKGROUND: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages...
February 17, 2018: Implementation Science: IS
Andrea C Tricco, Wasifa Zarin, Patricia Rios, Vera Nincic, Paul A Khan, Marco Ghassemi, Sanober Diaz, Ba' Pham, Sharon E Straus, Etienne V Langlois
BACKGROUND: It is unclear how to engage a wide range of knowledge users in research. We aimed to map the evidence on engaging knowledge users with an emphasis on policy-makers, health system managers, and policy analysts in the knowledge synthesis process through a scoping review. METHODS: We used the Joanna Briggs Institute guidance for scoping reviews. Nine electronic databases (e.g., MEDLINE), two grey literature sources (e.g., OpenSIGLE), and reference lists of relevant systematic reviews were searched from 1996 to August 2016...
February 12, 2018: Implementation Science: IS
Anne E Sales, Mary Ersek, Orna K Intrator, Cari Levy, Joan G Carpenter, Robert Hogikyan, Helen C Kales, Zach Landis-Lewis, Tobie Olsan, Susan C Miller, Marcos Montagnini, Vyjeyanthi S Periyakoil, Sheri Reder
The authors would like to correct errors in the original article [1] that may have lead readers to misinterpret the scope, evidence base and target population of VHA Handbook 1004.03 "Life-Sustaining Treatment (LST) Decisions: Eliciting, Documenting, and Honoring Patients' Values, Goals, and Preferences".
February 9, 2018: Implementation Science: IS
Lauren G Johnson, Allison Armstrong, Caroline M Joyce, Anne M Teitelman, Alison M Buttenheim
BACKGROUND: Developed countries, such as the USA, have achieved significant decreases in cervical cancer burden since the introduction of Pap smear-based programs in the 1960s. Due to implementation barriers and limited resources, many countries in sub-Saharan Africa (SSA) have been unable to attain such reductions. The purpose of this review is to evaluate implementation strategies used to improve the uptake and sustainability of cervical cancer prevention programs in SSA. METHODS: A reviewer (LJ) independently searched PubMed, Ovid/MEDLINE, Scopus, and Web of Science databases for relevant articles with the following search limits: English language, peer reviewed, and published between 1996 and 2017...
February 9, 2018: Implementation Science: IS
L Lennox, L Maher, J Reed
BACKGROUND: Improvement initiatives offer a valuable mechanism for delivering and testing innovations in healthcare settings. Many of these initiatives deliver meaningful and necessary changes to patient care and outcomes. However, many improvement initiatives fail to sustain to a point where their full benefits can be realised. This has led many researchers and healthcare practitioners to develop frameworks, models and tools to support and monitor sustainability. This work aimed to identify what approaches are available to assess and influence sustainability in healthcare and to describe the different perspectives, applications and constructs within these approaches to guide their future use...
February 9, 2018: Implementation Science: IS
Linnea Ferm, Charlotte Diana Nørregaard Rasmussen, Marie Birk Jørgensen
BACKGROUND: It is challenging to interpret the results of multifaceted interventions due to complex program theories that are difficult to measure in a quantifiable manner. The aims of this paper were, first, to develop a model for a comprehensive quantitative implementation evaluation and, second, to operationalize it in the process evaluation of the stepped-wedge cluster randomized controlled trial: "Prevention of low back pain and its consequences among nurses' aides in elderly care" to investigate if implementation differed across intervention components, steps, and settings (workplaces)...
February 8, 2018: Implementation Science: IS
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