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Implementation Science: IS

Daniel Pinto, Bruno Heleno, David S Rodrigues, Ana Luísa Papoila, Isabel Santos, Pedro A Caetano
BACKGROUND: Educational outreach visits are meant to improve the practice of health professionals by promoting face-to-face visits to deliver educational contents. They have been shown to change prescription behavior, but long-term effects are still uncertain. This trial aimed to determine if they improve family physician prescribing compared with passive guideline dissemination. METHODS: Parallel, open, superiority, and cluster-randomized trial. National Health Service primary care practices (clusters) were recruited in the Lisbon region-Portugal between March 2013 and January 2014...
September 5, 2018: Implementation Science: IS
Amy M Kilbourne, Shawna N Smith, Seo Youn Choi, Elizabeth Koschmann, Celeste Liebrecht, Amy Rusch, James L Abelson, Daniel Eisenberg, Joseph A Himle, Kate Fitzgerald, Daniel Almirall
BACKGROUND: Depressive and anxiety disorders affect 20-30% of school-age youth, most of whom do not receive adequate services, contributing to poor developmental and academic outcomes. Evidence-based practices (EBPs) such as cognitive behavioral therapy (CBT) can improve outcomes, but numerous barriers limit access among affected youth. Many youth try to access mental health services in schools, but school professionals (SPs: counselors, psychologists, social workers) are rarely trained adequately in CBT methods...
September 5, 2018: Implementation Science: IS
Kenneth K Mugwanya, Elizabeth Irungu, Elizabeth Bukusi, Nelly R Mugo, Josephine Odoyo, Elizabeth Wamoni, Kenneth Ngure, Jennifer F Morton, Kathryn Peebles, Sarah Masyuko, Gena Barnabee, Deborah Donnell, Ruanne Barnabas, Jessica Haberer, Gabrielle O'Malley, Jared M Baeten
BACKGROUND: Antiretroviral therapy (ART) for HIV-infected persons and pre-exposure prophylaxis (PrEP) for uninfected persons are extraordinarily effective strategies for HIV prevention. In Africa, the region which shoulders the highest HIV burden, HIV care is principally delivered through public health HIV care clinics, offering an existing platform to incorporate PrEP delivery and maximize ART and PrEP synergies. However, successfully bringing this integrated approach to scale requires an implementation science evaluation in public health settings...
September 4, 2018: Implementation Science: IS
K Grimmer, Q Louw, J M Dizon, S-M van Niekerk, D Ernstzen, C Wiysonge
BACKGROUND: Significant resources are required to write de novo clinical practice guidelines (CPGs). There are many freely-available CPGs internationally, for many health conditions. Developing countries rarely have the resources for de novo CPGs, and there could be efficiencies in using CPGs developed elsewhere. This paper outlines a novel process developed and tested in a resource-constrained country (South Africa) to synthesise findings from multiple international CPGs on allied health (AH) stroke rehabilitation...
August 29, 2018: Implementation Science: IS
Clayton R Cook, Chayna Davis, Eric C Brown, Jill Locke, Mark G Ehrhart, Gregory A Aarons, Madeline Larson, Aaron R Lyon
BACKGROUND: The Evidence-Based Practice Attitude Scale (EBPAS) is a widely used tool, but it has not been adapted and validated for use in schools, the most common setting where youth access behavioral health services. This study examined the factor structure, psychometric properties, and criterion-related validity of the school-adapted EBPAS in a sample of school-based behavioral health consultants. METHOD: A research team comprised of experts in implementation of evidence-based practices in schools along with the original developer adapted the EBPAS for the school setting...
August 22, 2018: Implementation Science: IS
Jennifer E Johnson, Shannon Wiltsey-Stirman, Alla Sikorskii, Ted Miller, Amanda King, Jennifer L Blume, Xuan Pham, Tiffany A Moore Simas, Ellen Poleshuck, Rebecca Weinberg, Caron Zlotnick
BACKGROUND: More research on sustainment of interventions is needed, especially return on investment (ROI) studies to determine cost-benefit trade-offs for effort required to sustain and how much is gained when effective programs are sustained. The ROSE sustainment (ROSES) study uses a sequential multiple assignment randomized (SMART) design to evaluate the effectiveness and cost-effectiveness of a stepwise approach to sustainment of the ROSE postpartum depression prevention program in 90 outpatient clinics providing prenatal care to pregnant women on public assistance...
August 22, 2018: Implementation Science: IS
Melanie Kingsland, Emma Doherty, Amy E Anderson, Kristy Crooks, Belinda Tully, Danika Tremain, Tracey W Tsang, John Attia, Luke Wolfenden, Adrian J Dunlop, Nicole Bennett, Mandy Hunter, Sarah Ward, Penny Reeves, Ian Symonds, Chris Rissel, Carol Azzopardi, Andrew Searles, Karen Gillham, Elizabeth J Elliott, John Wiggers
BACKGROUND: Despite clinical guideline recommendations, implementation of antenatal care addressing alcohol consumption by pregnant women is limited. Implementation strategies addressing barriers to such care may be effective in increasing care provision. The aim of this study is to examine the effectiveness, cost and cost-effectiveness of a multi-strategy practice change intervention in increasing antenatal care addressing the consumption of alcohol by pregnant women. METHODS: The study will be a randomised, stepped-wedge controlled trial conducted in three sectors in a health district in New South Wales, Australia...
August 20, 2018: Implementation Science: IS
Stijn Van de Velde, Annemie Heselmans, Nicolas Delvaux, Linn Brandt, Luis Marco-Ruiz, David Spitaels, Hanne Cloetens, Tiina Kortteisto, Pavel Roshanov, Ilkka Kunnamo, Bert Aertgeerts, Per Olav Vandvik, Signe Flottorp
BACKGROUND: Computerised clinical decision support (CDS) can potentially better inform decisions, and it can help with the management of information overload. It is perceived to be a key component of a learning health care system. Despite its increasing implementation worldwide, it remains uncertain why the effect of CDS varies and which factors make CDS more effective. OBJECTIVE: To examine which factors make CDS strategies more effective on a number of outcomes, including adherence to recommended practice, patient outcome measures, economic measures, provider or patient satisfaction, and medical decision quality...
August 20, 2018: Implementation Science: IS
S McHugh, C Sinnott, E Racine, S Timmons, M Byrne, P M Kearney
BACKGROUND: Implementation strategies are needed to ensure that evidence-based healthcare interventions are adopted successfully. However, strategies are generally poorly described and those used in everyday practice are seldom reported formally or fully understood. Characterising the active ingredients of existing strategies is necessary to test and refine implementation. We examined whether an implementation strategy, delivered across multiple settings targeting different stakeholders to support a fall prevention programme, could be characterised using the Behaviour Change Technique (BCT) Taxonomy...
August 20, 2018: Implementation Science: IS
Roman Kislov, Paul M Wilson, Sarah Knowles, Ruth Boaden
BACKGROUND: Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were funded by NIHR in England in 2008 and 2014 as partnerships between universities and surrounding health service organisations, focused on improving the quality of healthcare through the conduct and application of applied health research. The aim of this review is to synthesise learning from evaluations of the CLAHRCs. METHODS: Fifteen databases including CINAHL, MEDLINE, EMBASE and PsycINFO were searched to identify any evaluations of CLAHRCs...
August 15, 2018: Implementation Science: IS
Kathy Goggin, Emily A Hurley, Jolly Beyeza-Kashesya, Violet Gwokyalya, Sarah Finocchario-Kessler, Josephine Birungi, Deborah Mindry, Rhoda K Wanyenze, Glenn J Wagner
BACKGROUND: About 40% of HIV-positive women in sub-Saharan Africa become pregnant post-diagnosis. Despite about half of their pregnancies being planned, safer conception methods (SCM) are underutilized among serodiscordant couples, partially due to the fact that safer conception counseling (SCC) has not been integrated into routine HIV family planning (FP) services. METHODS: Our Choice is a comprehensive FP intervention that promotes unbiased childbearing consultations to ensure clients receive SCC or contraception services to achieve their desired reproductive goals...
August 14, 2018: Implementation Science: IS
Helen A Vidgen, Penelope V Love, Sonia E Wutzke, Lynne A Daniels, Chris E Rissel, Christine Innes-Hughes, Louise A Baur
BACKGROUND: The prevalence of childhood obesity poses an urgent global challenge. The World Health Organization (WHO) Commission on Ending Childhood Obesity recommends the provision of appropriate family-based, lifestyle weight management services through universal health care to support families of children with overweight or obesity; however, there are few examples of their implementation 'at scale'. The purpose of this research was to compare and contrast the impact of system and organisational factors on the implementation of childhood obesity management services within two Australian States (New South Wales and Queensland) to comprehensively describe their influence on the achievement of the WHO recommendation...
August 7, 2018: Implementation Science: IS
Joseph E Glass, Jennifer F Bobb, Amy K Lee, Julie E Richards, Gwen T Lapham, Evette Ludman, Carol Achtmeyer, Ryan M Caldeiro, Rebecca Parrish, Emily C Williams, Paula Lozano, Katharine A Bradley
BACKGROUND: Experts recommend that alcohol-related care be integrated into primary care (PC) to improve prevention and treatment of unhealthy alcohol use. However, few healthcare systems offer such integrated care. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington (KPWA) partnered to design a high-quality program of evidence-based care for unhealthy alcohol use: the Sustained Patient-centered Alcohol-related Care (SPARC) program. SPARC implements systems of clinical care designed to increase both prevention and treatment of unhealthy alcohol use...
August 6, 2018: Implementation Science: IS
Kathy Trieu, Jacqui Webster, Stephen Jan, Silvia Hope, Take Naseri, Merina Ieremia, Colin Bell, Wendy Snowdon, Marj Moodie
BACKGROUND: Evidence for recommended interventions to reduce population salt intake come from high-income countries, but it is unknown if these can be successfully replicated in low- and middle-income countries. This process evaluation investigated the reach, dose/adoption, fidelity, cost, and context of a national salt reduction program of interventions in Samoa. METHODS: Monitoring and Action on Salt in Samoa (MASIMA) was a pre- and post-intervention study of a government-led strategy to lower population salt intake comprising awareness campaigns, community mobilization and policy and environmental changes...
August 6, 2018: Implementation Science: IS
Julia E Moore, Shusmita Rashid, Jamie S Park, Sobia Khan, Sharon E Straus
BACKGROUND: Few training opportunities are available for implementation practitioners; we designed the Practicing Knowledge Translation (PKT) to address this gap. The goal of PKT is to train practitioners to use evidence and apply implementation science in healthcare settings. The aim of this study was to describe PKT and evaluate participant use of implementation science theories, models, and frameworks (TMFs), knowledge, self-efficacy, and satisfaction and feedback on the course. METHODS: PKT was delivered to implementation practitioners between September 2015 and February 2016 through a 3-day workshop, 11 webinars...
August 6, 2018: Implementation Science: IS
Lara J Cooke, Diane Duncan, Laura Rivera, Shawn K Dowling, Christopher Symonds, Heather Armson
BACKGROUND: Audit and feedback interventions may be strengthened using social interaction. With this in mind, the Calgary office of the Alberta Physician Learning Program developed a process for audit and group feedback for physician groups. As a part of a larger project to develop a practical approach to the design and implementation of audit and group feedback projects, we explored patterns of physician behavior during facilitated audit and group feedback sessions. METHODS: Six audit and group feedback sessions were recorded, transcribed, and analyzed thematically to derive a conceptual model of physicians' behaviors during audit and group feedback sessions...
July 31, 2018: Implementation Science: IS
Kea Turner, Justin G Trogdon, Morris Weinberger, Angela M Stover, Stefanie Ferreri, Joel F Farley, Neepa Ray, Michael Patti, Chelsea Renfro, Christopher M Shea
BACKGROUND: Many state Medicaid programs are implementing pharmacist-led medication management programs to improve outcomes for high-risk beneficiaries. There are a limited number of studies examining implementation of these programs, making it difficult to assess why program outcomes might vary across organizations. To address this, we tested the applicability of the organizational theory of innovation implementation effectiveness to examine implementation of a community pharmacy Medicaid medication management program...
July 31, 2018: Implementation Science: IS
Anders Malthe Bach-Mortensen, Brittany C L Lange, Paul Montgomery
BACKGROUND: The third sector is becoming a growing provider of public, social, and health services. However, there is little evidence on the effectiveness of third sector organisations (TSOs), and their capacity to implement evidence-based interventions (EBIs). Understanding implementation aspects of service delivery remains an important issue in clinical practice, but is poorly understood in the context of TSOs. This is problematic, since implementation issues are known to be critical for effective intervention outcomes...
July 30, 2018: Implementation Science: IS
E Pallangyo, C Mbekenga, P Olsson, L Eriksson, A Bergström
BACKGROUND: Implementation of evidence into practice is inadequate in many low-income countries, contributing to the low-quality care of mothers and newborns. This study explored strategies used in a facilitation intervention to improve postpartum care (IPPC) in a low-resource suburb in Dar es Salaam, Tanzania. The intervention was conducted during 1 year in government-owned health institutions providing reproductive and child health services. The institutions were divided into six clusters based on geographic proximity, and the healthcare providers of postpartum care (PPC) (n = 100) in these institutions formed IPPC teams...
July 28, 2018: Implementation Science: IS
Alicia C Bunger, Nathan Doogan, Rochelle F Hanson, Sarah A Birken
BACKGROUND: Successful implementation depends on the transfer of knowledge and expertise among clinicians, which can occur when professionals seek advice from one another. This study examines advice-seeking patterns among mental health clinicians participating in learning collaboratives (a multi-component implementation and quality improvement strategy) to implement trauma-focused cognitive behavioral therapy (TF-CBT). We apply transactive memory system theory, which explains how professionals access and retrieve knowledge, to examine factors associated with the evolution of advice-seeking relationships during implementation...
July 28, 2018: Implementation Science: IS
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