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Implementation Science: IS

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https://www.readbyqxmd.com/read/28915897/development-of-a-complex-intervention-to-promote-appropriate-prescribing-and-medication-intensification-in-poorly-controlled-type-2-diabetes-mellitus-in-irish-general-practice
#1
Mark E Murphy, Molly Byrne, Atieh Zarabzadeh, Derek Corrigan, Tom Fahey, Susan M Smith
BACKGROUND: Poorly controlled type 2 diabetes mellitus (T2DM) can be seen as failure to meet recommended targets for management of key risk factors including glycaemic control, blood pressure and lipids. Poor control of risk factors is associated with significant morbidity, mortality and healthcare costs. Failure to intensify medications for patients with poor control of T2DM when indicated is called clinical inertia and is one contributory factor to poor control of T2DM. We aimed to develop a theory and evidence-based complex intervention to improve appropriate prescribing and medication intensification in poorly controlled T2DM in Irish general practice...
September 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28915822/what-hinders-the-uptake-of-computerized-decision-support-systems-in-hospitals-a-qualitative-study-and-framework-for-implementation
#2
Elisa G Liberati, Francesca Ruggiero, Laura Galuppo, Mara Gorli, Marien González-Lorenzo, Marco Maraldi, Pietro Ruggieri, Hernan Polo Friz, Giuseppe Scaratti, Koren H Kwag, Roberto Vespignani, Lorenzo Moja
BACKGROUND: Advanced Computerized Decision Support Systems (CDSSs) assist clinicians in their decision-making process, generating recommendations based on up-to-date scientific evidence. Although this technology has the potential to improve the quality of patient care, its mere provision does not guarantee uptake: even where CDSSs are available, clinicians often fail to adopt their recommendations. This study examines the barriers and facilitators to the uptake of an evidence-based CDSS as perceived by diverse health professionals in hospitals at different stages of CDSS adoption...
September 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28915815/designing-an-implementation-intervention-with-the-behaviour-change-wheel-for-health-provider-smoking-cessation-care-for-australian-indigenous-pregnant-women
#3
Gillian S Gould, Yael Bar-Zeev, Michelle Bovill, Lou Atkins, Maree Gruppetta, Marilyn J Clarke, Billie Bonevski
BACKGROUND: Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS...
September 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28886709/improving-the-production-of-applied-health-research-findings-insights-from-a-qualitative-study-of-operational-research
#4
Sonya Crowe, Simon Turner, Martin Utley, Naomi J Fulop
BACKGROUND: Knowledge produced through applied health research is often of a form not readily accessible to or actionable by policymakers and practitioners, which hinders its implementation. Our aim was to identify research activities that can support the production of knowledge tailored to inform policy and practice. To do this, we studied an operational research approach to improving the production of applied health research findings. METHODS: A 2-year qualitative study was conducted of the operational research contribution to a multidisciplinary applied health research project that was successful in rapidly informing national policy...
September 8, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28877746/-scaling-out-evidence-based-interventions-to-new-populations-or-new-health-care-delivery-systems
#5
Gregory A Aarons, Marisa Sklar, Brian Mustanski, Nanette Benbow, C Hendricks Brown
BACKGROUND: Implementing treatments and interventions with demonstrated effectiveness is critical for improving patient health outcomes at a reduced cost. When an evidence-based intervention (EBI) is implemented with fidelity in a setting that is very similar to the setting wherein it was previously found to be effective, it is reasonable to anticipate similar benefits of that EBI. However, one goal of implementation science is to expand the use of EBIs as broadly as is feasible and appropriate in order to foster the greatest public health impact...
September 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28865479/developing-a-comprehensive-definition-of-sustainability
#6
Julia E Moore, Alekhya Mascarenhas, Julie Bain, Sharon E Straus
BACKGROUND: Understanding sustainability is one of the significant implementation science challenges. One of the big challenges in researching sustainability is the lack of consistent definitions in the literature. Most implementation studies do not present a definition of sustainability, even when assessing sustainability. The aim of the current study was to systematically develop a comprehensive definition of sustainability based on definitions already used in the literature. METHODS: We searched for knowledge syntheses of sustainability and abstracted sustainability definitions from the articles identified through any relevant systematic and scoping reviews...
September 2, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28865474/barriers-and-facilitators-to-implementation-of-va-home-based-primary-care-on-american-indian-reservations-a-qualitative-multi-case-study
#7
B Josea Kramer, Sarah D Cote, Diane I Lee, Beth Creekmur, Debra Saliba
BACKGROUND: Veterans Health Affairs (VA) home-based primary care (HBPC) is an evidence-based interdisciplinary approach to non-institutional long-term care that was developed in urban settings to provide longitudinal care for vulnerable older patients. Under the authority of a Memorandum of Understanding between VA and Indian Health Service (IHS) to improve access to healthcare, 14 VA medical centers (VAMC) independently initiated plans to expand HBPC programs to rural American Indian reservations and 12 VAMC successfully implemented programs...
September 2, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28851459/psychometric-assessment-of-three-newly-developed-implementation-outcome-measures
#8
Bryan J Weiner, Cara C Lewis, Cameo Stanick, Byron J Powell, Caitlin N Dorsey, Alecia S Clary, Marcella H Boynton, Heather Halko
BACKGROUND: Implementation outcome measures are essential for monitoring and evaluating the success of implementation efforts. Yet, currently available measures lack conceptual clarity and have largely unknown reliability and validity. This study developed and psychometrically assessed three new measures: the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). METHODS: Thirty-six implementation scientists and 27 mental health professionals assigned 31 items to the constructs and rated their confidence in their assignments...
August 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28841894/an-exploration-of-group-based-hiv-aids-treatment-and-care-models-in-sub-saharan-africa-using-a-realist-evaluation-intervention-context-actor-mechanism-outcome-heuristic-tool-a-systematic-review
#9
REVIEW
Ferdinand C Mukumbang, Sara Van Belle, Bruno Marchal, Brian van Wyk
INTRODUCTION: It is increasingly acknowledged that differentiated care models hold potential to manage large volumes of patients on antiretroviral therapy (ART). Various group-based models of ART service delivery aimed at decongesting local health facilities, encouraging patient retention in care, and enhancing adherence to medication have been implemented across sub-Saharan Africa. Evidence from the literature suggests that these models of ART service delivery are more effective than corresponding facility-based care and superior to individual-based models...
August 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28836996/random-or-predictable-adoption-patterns-of-chronic-care-management-practices-in-physician-organizations
#10
Isomi M Miake-Lye, Emmeline Chuang, Hector P Rodriguez, Gerald F Kominski, Elizabeth M Yano, Stephen M Shortell
BACKGROUND: Theories, models, and frameworks used by implementation science, including Diffusion of Innovations, tend to focus on the adoption of one innovation, when often organizations may be facing multiple simultaneous adoption decisions. For instance, despite evidence that care management practices (CMPs) are helpful in managing chronic illness, there is still uneven adoption by physician organizations. This exploratory paper leverages this natural variation in uptake to describe inter-organizational patterns in adoption of CMPs and to better understand how adoption choices may be related to one another...
August 24, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28830568/increasing-the-provision-of-preventive-care-by-community-healthcare-services-a-stepped-wedge-implementation-trial
#11
John Wiggers, Kathleen McElwaine, Megan Freund, Libby Campbell, Jenny Bowman, Paula Wye, Luke Wolfenden, Danika Tremain, Daniel Barker, Carolyn Slattery, Karen Gillham, Kate Bartlem
BACKGROUND: Although clinical guidelines recommend the provision of care to reduce client chronic disease risk behaviours, such care is provided sub-optimally by primary healthcare providers. A study was undertaken to determine the effectiveness of an intervention in increasing community-based clinician implementation of multiple elements of recommended preventive care for four risk behaviours. METHODS: A three-group stepped-wedge trial was undertaken with all 56 community-based primary healthcare facilities in one health district in New South Wales, Australia...
August 22, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28814328/building-capacity-for-dissemination-and-implementation-research-one-university-s-experience
#12
Ross C Brownson, Enola K Proctor, Douglas A Luke, Ana A Baumann, Mackenzie Staub, Matthew T Brown, Mallory Johnson
BACKGROUND: While dissemination and implementation (D&I) science has grown rapidly, there is an ongoing need to understand how to build and sustain capacity in individuals and institutions conducting research. There are three inter-related domains for capacity building: people, settings, and activities. Since 2008, Washington University in St. Louis has dedicated significant attention and resources toward building D&I research capacity. This paper describes our process, challenges, and lessons with the goal of informing others who may have similar aims at their own institution...
August 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28797270/implementing-the-teen-marijuana-check-up-in-schools-a-study-protocol
#13
Bryan Hartzler, Aaron R Lyon, Denise D Walker, Lauren Matthews, Kevin M King, Kathryn E McCollister
BACKGROUND: Substance misuse is now encountered in settings beyond addiction specialty care, with schools a point-of-contact for student access to behavioral health services. Marijuana is a leading impetus for adolescent treatment admissions despite declining risk perception, for which the Teen Marijuana Check-Up (TMCU)-a tailored adaptation of motivational enhancement therapy-offers an efficacious service option. To bridge the knowledge gap concerning effective and affordable technical assistance strategies for implementing empirically supported services, the described trial will test such a strategy to facilitate school-based TMCU implementation...
August 10, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28784155/specification-of-implementation-interventions-to-address-the-cascade-of-hiv-care-and-treatment-in-resource-limited-settings-a-systematic-review
#14
REVIEW
Matthew D Hickey, Thomas A Odeny, Maya Petersen, Torsten B Neilands, Nancy Padian, Nathan Ford, Zachary Matthay, David Hoos, Meg Doherty, Chris Beryer, Stefan Baral, Elvin H Geng
BACKGROUND: The global response to HIV has started over 18 million persons on life-saving antiretroviral therapy (ART)-the vast majority in low- and middle-income countries (LMIC)-yet substantial gaps remain: up to 40% of persons living with HIV (PLHIV) know their status, while another 30% of those who enter care are inadequately retained after starting treatment. Identifying strategies to enhance use of treatment is urgently needed, but the conceptualization and specification of implementation interventions is not always complete...
August 8, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28768546/five-years-experience-of-an-annual-course-on-implementation-science-an-evaluation-among-course-participants
#15
Siw Carlfjord, Kerstin Roback, Per Nilsen
BACKGROUND: Increasing interest in implementation science has generated a demand for education and training opportunities for researchers and practitioners in the field. However, few implementation science courses have been described or evaluated in the scientific literature. The aim of the present study was to provide a short- and long-term evaluation of the implementation training at Linköping University, Sweden. METHODS: Two data collections were carried out...
August 2, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28764753/supporting-prescribing-in-older-people-with-multimorbidity-and-significant-polypharmacy-in-primary-care-sppire-a-cluster-randomised-controlled-trial-protocol-and-pilot
#16
Caroline McCarthy, Barbara Clyne, Derek Corrigan, Fiona Boland, Emma Wallace, Frank Moriarty, Tom Fahey, Carmel Hughes, Paddy Gillespie, Susan M Smith
BACKGROUND: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care...
August 1, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28764752/facilitated-interprofessional-implementation-of-a-physical-rehabilitation-guideline-for-stroke-in-inpatient-settings-process-evaluation-of-a-cluster-randomized-trial
#17
Nancy M Salbach, Sharon Wood-Dauphinee, Johanne Desrosiers, Janice J Eng, Ian D Graham, Susan B Jaglal, Nicol Korner-Bitensky, Marilyn MacKay-Lyons, Nancy E Mayo, Carol L Richards, Robert W Teasell, Merrick Zwarenstein, Mark T Bayley
BACKGROUND: The Stroke Canada Optimization of Rehabilitation by Evidence-Implementation Trial (SCORE-IT) showed that a facilitated knowledge translation (KT) approach to implementing a stroke rehabilitation guideline was more likely than passive strategies to improve functional walking capacity, but not gross manual dexterity, among patients in rehabilitation hospitals. This paper presents the results of a planned process evaluation designed to assess whether the type and number of recommended treatments implemented by stroke teams in each group would help to explain the results related to patient outcomes...
August 1, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28764728/how-do-stakeholders-from-multiple-hierarchical-levels-of-a-large-provincial-health-system-define-engagement-a-qualitative-study
#18
Jill M Norris, Deborah E White, Lorelli Nowell, Kelly Mrklas, Henry T Stelfox
BACKGROUND: Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. METHODS: Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews...
August 1, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28754140/assessing-citation-networks-for-dissemination-and-implementation-research-frameworks
#19
Ted A Skolarus, Todd Lehmann, Rachel G Tabak, Jenine Harris, Jesse Lecy, Anne E Sales
BACKGROUND: A recent review of frameworks used in dissemination and implementation (D&I) science described 61 judged to be related either to dissemination, implementation, or both. The current use of these frameworks and their contributions to D&I science more broadly has yet to be reviewed. For these reasons, our objective was to determine the role of these frameworks in the development of D&I science. METHODS: We used the Web of Science™ Core Collection and Google Scholar™ to conduct a citation network analysis for the key frameworks described in a recent systematic review of D&I frameworks (Am J Prev Med 43(3):337-350, 2012)...
July 28, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28754130/teasing-apart-the-tangled-web-of-influence-of-policy-dialogues-lessons-from-a-case-study-of-dialogues-about-healthcare-reform-options-for-canada
#20
Gillian Mulvale, Samantha A McRae, Sandra Milicic
BACKGROUND: The knowledge exchange literature suggests that policy dialogues are intended to enhance short-, medium- and long-term capacities of individuals, organizations and health systems to use evidence to inform policy-making. Key features of effective dialogues have been suggested, but the linkages between these features and the realization of improved capacities for evidence-informed policy-making among dialogue attendees and the subsequent influence on policy-making activities are not well understood...
July 28, 2017: Implementation Science: IS
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