Implementation science communications最新文献

{"title":"Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings.","authors":"Kirsten Austad, Erika G Cordova-Ramos, Alicia Fernandez, Mari-Lynn Drainoni","doi":"10.1186/s43058-025-00753-6","DOIUrl":"https://doi.org/10.1186/s43058-025-00753-6","url":null,"abstract":"<p><p>As the population of individuals with non-dominant language preference (NDLP) continues to grow, the field of implementation science has yet to fully address the unique barriers that this population faces in accessing evidence-based interventions (EBIs). Traditional models of cultural adaptation have been designed primarily for single linguistic or ethnic groups, focusing on aligning interventions with specific cultural values, beliefs, and practices. While effective within narrowly defined populations, this approach is not scalable to high-diversity settings where multiple NDLP groups are served simultaneously. In this Commentary, we argue for a reconceptualization of how implementation science approaches language barriers, advocating for all implementation efforts to consider language as a core determinant of success. We highlight how two relatively recent tools developed within implementation science-the Core Function and Form Framework and causal pathway diagrams-can advance EBI adaptation for populations with NDLP. We propose a highly scalable approach that systematically assesses the linguistic, cultural, and social needs of each individual and uses these data to guide individualized tailoring of an intervention, building on the emerging model of \"personalized adaptation.\" We highlight the need to innovate methods to ensure an individualized approach to EBI adaptation is feasible, scalable, and led by communities, with input from end-users. By harnessing the wisdom of the fields of implementation science and cultural adaptation, interventions can be adapted to the linguistic, cultural, and social needs of populations with NDLP to bring us closer to health equity in a diverse world.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Going above and beyond\" for implementation in the education sector: extension and validation of the School Implementation Citizenship Behavior Scale (SICBS).","authors":"Catherine M Corbin, Mark G Ehrhart, Eric C Brown, Jill Locke, Clayton R Cook, Gregory A Aarons, Aaron R Lyon","doi":"10.1186/s43058-025-00748-3","DOIUrl":"https://doi.org/10.1186/s43058-025-00748-3","url":null,"abstract":"<p><strong>Background: </strong>Employee behaviors that strategically support implementation (i.e., implementation citizenship behavior [ICB]) theoretically promote the adoption and high-fidelity use of evidence-based practices (EBPs). ICB (e.g., helping colleagues overcome implementation barriers) may vary across contexts, including schools where children are most likely to access and receive mental and behavioral health services. Pragmatic measures are needed to advance nascent research on school-based ICB and inform how these behaviors can be used to support successful implementation. The current study expanded the Implementation Citizenship Behavior Scale (ICBS) to create and validate the School Implementation Citizenship Behavior Scale (SICBS) in a sample of elementary school teachers implementing evidence-based prevention programs to support children's mental and behavioral health.</p><p><strong>Methods: </strong>Based on subject matter expert feedback, items were refined from the original ICBS and items for two new subscales (taking initiative, advocacy) were created for the SICBS. A sample of 441 public school teachers from 52 elementary schools in the Midwest and Western United States of America completed a survey that included the SICBS and additional measures to assess convergent and divergent validity. SICBS was refined and validated via examination of item characteristics curves to reduce items and develop a pragmatic instrument, confirmatory factor analyses to evaluate the hypothesized measurement structure, and assessment of convergent and divergent validity.</p><p><strong>Results: </strong>The original two ICBS subscales (helping others, keeping informed) were retained, and two new three-item subscales resulted from item reduction analyses (taking initiative, advocacy). The hypothesized second-order factor model was generally well fit to the data (CFI = .99, TLI = .99, RMSEA = .09), all first- (λs = .85-.96) and second-order factor loadings (λs = .93-.95) were high. All SICBS subscales demonstrated acceptable reliability (αs = .88-.92). Convergent validity was evidenced by moderate correlations with organizational citizenship behavior items (rs = .42-.49). Divergent validity was demonstrated by weak correlations with teachers' beliefs about teaching (rs = .31-.38) and null correlations with most school demographics.</p><p><strong>Conclusion: </strong>Results support the structural, convergent, and divergent validity of the 12-item, 4-factor SICBS. The SICBS provides a deeper understanding of individual implementer actions that may serve as implementation mechanisms or outcomes.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"64"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crowdsourcing Ideas for the Implementation of Long-Acting Injectable PrEP among Sexual Minority Men in Chicago through an Innovation Tournament.","authors":"Amelia E Van Pelt, Elizabeth Casline, Byrd G M Cook, Gregory Phillips, Jorge Cestou, Brian Mustanski, Rana Saber, Rinad S Beidas","doi":"10.1186/s43058-025-00750-9","DOIUrl":"https://doi.org/10.1186/s43058-025-00750-9","url":null,"abstract":"<p><strong>Background: </strong>Reducing HIV incidence requires the effective implementation of evidence-based prevention practices. In Chicago, HIV disproportionately impacts sexual minority men (SMM). Long-acting injectable cabotegravir (CAB-LA) offers a new form of evidence-based HIV prevention, thus requiring a strategic implementation approach. To maximize uptake of CAB-LA in Chicago, co-designing implementation strategies with end-users is critical. This research employed the participatory method of an innovation tournament to inform implementation of CAB-LA among SMM, particularly Black and Latino populations.</p><p><strong>Methods: </strong>A virtual innovation tournament was conducted in English and Spanish to enable participants to share ideas on how to implement CAB-LA for SMM 12 years and older in Chicago. Innovation tournaments follow a three-step process: 1) participant submission of ideas in response to a prompt, 2) participant feedback on ideas, and 3) evaluation of ideas by a committee. Participants ≥ 13 years old were recruited through physical advertisement (e.g., banners on public transportation), digital advertisement (e.g., social media), and in-person advertisement (e.g., clinic). A committee of constituents with diverse expertise convened to evaluate the ideas on acceptability, appropriateness, feasibility, and impact. Ideas were coded by strategy type (implementation vs dissemination).</p><p><strong>Results: </strong>Forty-two participants completed 54 submissions comprised of 73 discrete ideas. Participants proposed both dissemination (56.2%) and implementation (42.5%) strategies. Ideas described strategies to increase awareness (e.g., campaign on social media and dating apps, identification of LGBTQ ambassador), reduce cost (e.g., shot subsidization, transportation voucher), integrate care (e.g., STI services, pharmacies), and partner with community spaces (e.g., pop-up clinics, schools). The top three ideas based on committee scores suggested implementation through at-home visits, education of providers with queer patients, and administration in pharmacies.</p><p><strong>Discussion: </strong>Given that the co-design of implementation strategies often does not involve the participation of individuals with lived experiences, this work will center the voices of those who will benefit most. Specifically, this research will contribute to the production of implementation strategies co-designed with end users, which can guide plans for CAB-LA integration in Chicago and provide insights for other regions. As the first innovation tournament focused on HIV prevention, this research can provide a framework for participatory approaches across the care continuum.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"65"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a novel, multi-method approach to evaluate the quality of self-report survey data in organizational readiness research.","authors":"Derek W Craig, Jocelyn Hunyadi, Timothy J Walker, Lauren Workman, Maria McClam, Andrea Lamont, Joe R Padilla, Pamela Diamond, Abraham Wandersman, Maria E Fernandez","doi":"10.1186/s43058-025-00751-8","DOIUrl":"10.1186/s43058-025-00751-8","url":null,"abstract":"<p><strong>Background: </strong>Self-report measures are essential in implementation science since many phenomena are difficult to assess directly. Nevertheless, cognitively demanding surveys increase the prevalence of careless and inattentive responses. Assessing response quality is critical to improving data validity, yet recommendations for determining response quality vary. To address this, we aimed to 1) apply a multi-method approach to assess the quality of self-report survey data in a study aimed to validate a measure of organizational readiness, 2) compare readiness scores among responses categorized as high- and low-quality, and 3) examine individual characteristics associated with low-quality responses.</p><p><strong>Methods: </strong>We surveyed federally qualified health center staff to assess organizational readiness for implementing evidence-based interventions to increase colorectal cancer screening. The survey was informed by the R = MC² heuristic, which proposes that readiness consists of three components: Motivation (M), Innovation-Specific Capacity (ISC), and General Capacity (GC). We determined response quality (high/low) using two assessment methods: survey completion time and monotonic response patterns (MRPs). T-tests examined associations between readiness scores and response quality, and regression models examined differences in response quality by individual characteristics (e.g., age, role, implementation involvement).</p><p><strong>Results: </strong>The sample consisted of 474 responses from 57 clinics. The average survey time was 24.3 min, and 42 respondents (8.9%) had MRPs on all readiness components. The number of low-quality responses varied by assessment method (range = 42-98). Survey responses classified as low quality had higher readiness scores (M, ISC, GC, p < 0.01). Age (p = 0.01), race (p < 0.01), and implementation involvement (p = 0.04) were inversely associated with survey completion time, whereas older age (p = 0.01) and more years worked at the clinic (p = 0.03) were associated with higher response quality. Quality improvement staff and clinic management were less likely to provide low-quality responses (p = 0.04).</p><p><strong>Conclusions: </strong>Our findings suggest that readiness scores can be inflated by low-quality responses, and individual characteristics play a significant role in data quality. There is a need to be aware of who is completing surveys and the context in which surveys are distributed to improve the interpretation of findings and make the measurement of implementation-related constructs more precise.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"63"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning for scale: analysis of adaptations and contextual factors influencing scale-up of the QUALI-DEC intervention to optimize caesarean section use.","authors":"Soha El-Halabi, Claudia Hanson, Alexandre Dumont, Amanda Cleeve, Helle Mölsted Alvesson, Charles Kaboré, Guillermo Carroli, Pisake Lumbiganon, Quoc Nhu Hung Mac, Ana Pilar Betran, Kristi Sidney Annerstedt, Meghan A Bohren, Karen Zamboni","doi":"10.1186/s43058-025-00737-6","DOIUrl":"10.1186/s43058-025-00737-6","url":null,"abstract":"<p><strong>Background: </strong>Researchers are encouraged to plan for scale through purposeful and guided assessment of scalability of an intervention. This study analysed factors potentially influencing scale-up and synthesised early adaptations of the QUALI-DEC intervention aiming to improve the appropriate use of caesarean section. The intervention consists of opinion leader engagement, audit and feedback for caesarean section, a tool to help women make an informed decision on the mode of birth, and labour companionship.</p><p><strong>Methods: </strong>We conducted a framework analysis, which was guided by the scalability assessment framework by Zamboni et al., a 34-item checklist with a three-point scale. We used data from the formative research including a document review, hospital readiness assessment and qualitative interviews conducted between March 2019 and May 2020 in 32 facilities across Argentina, Burkina Faso, Thailand, and Viet Nam. Data were deductively coded based on the four dimensions of the scalability framework. Our findings were validated with implementing partners across countries.</p><p><strong>Results: </strong>We identified the perceived relevance of the intervention by women and providers and the presence of relevant key clinical guidelines as factors that may ease scalability of QUALI-DEC. Labour companionship and the decision-analysis tool were perceived as harder to scale-up and requiring additional changes to existing healthcare structures. Most of the study facilities reported high workload and time constraints as implementation barriers. Thailand was the only country with a national policy to reduce unnecessary caesarean sections. Legal disputes were common and followed a structured process in Thailand and Argentina, which may support preference of caesarean section due to fear of litigation. Early adaptations included development, revision and translation of educational material, monetary compensation of opinion leaders and reaching consensus on clinical guidelines to be used across hospitals, most of which are deemed conducive to scale up.</p><p><strong>Conclusions: </strong>Planning for scale-up is a key feature of the QUALI-DEC intervention. Scale-up may not be guaranteed at this point of the intervention since effectiveness and cost-effectiveness are not demonstrated yet. However, the investment in studying scale-up opportunities is a core contribution to implementation research. This exercise informed implementation and scale-up strategies of the QUALI-DEC intervention.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"61"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the implementation research logic model to examine high-intensity resistance rehabilitation implementation in skilled nursing facilities: a mixed methods multi-site case study.","authors":"Lauren A Hinrichs-Kinney, Danielle Derlein, Mattie E Pontiff, Daniel Malone, Jodi Summers Holtrop, Jennifer E Stevens-Lapsley","doi":"10.1186/s43058-025-00747-4","DOIUrl":"10.1186/s43058-025-00747-4","url":null,"abstract":"<p><strong>Background: </strong>Implementing evidence-based rehabilitation in skilled nursing facilities (SNFs) is essential for enhancing physical function outcomes and mitigating risk of adverse events. Best implementation approaches in this complex setting are unknown. This study uses the Implementation Research Logic Model (IRLM) to retrospectively examine the implementation of high-intensity resistance rehabilitation (HIR) in SNFs, aiming to elucidate contextual factors and pathways that could enhance future HIR implementation endeavors.</p><p><strong>Methods: </strong>We conducted a convergent, mixed-methods multi-site case study (n = 8 sites). A standardized implementation strategy was employed, allowing sites to adapt this approach. HIR use was measured using the Provider Report of Sustainment Scale (PRESS). Contextual factors were identified using the Practical Robust Implementation and Sustainability Model (PRISM) through study-specific questionnaires and validated measures (Inner Setting Scale, Provider Perspective of Team Effectiveness, Evidence Based Practice Attitudes Scale, Perceived Characteristics of Intervention Scale, Self-Defined Burnout Measure, and Utrecht Engagement Scale), and analyzed descriptively. Interviews and focus groups with leadership and clinicians revealed contextual factors and strategies influencing implementation. Heat maps visualized site patterns, while an IRLM proposed provisional implementation pathways.</p><p><strong>Results: </strong>PRESS scores ranged from 3.75 (0.17) to 2.33 (0.67), indicating all sites implemented HIR to at least a \"moderate extent\". Higher-implementing sites demonstrated full-team ability to adapt HIR to diverse patients. Differentiating contextual factors between higher and lower implementing sites included clinician perspectives, site infrastructure, and satisfaction with leadership. Higher-implementing sites employed a higher volume of site-initiated implementation strategies, notably having a champion and patient engagement. Pathways that appeared to contribute to higher implementation extent included: 1) overcoming inertia of current practice through HIR salience, 2) overcoming clinician concerns of patient compatibility through affirmative experiences, 3) addressing clinician perspective of complexity with session planning, and 4) optimizing patient rehabilitation mindset through encouraging environments.</p><p><strong>Conclusion: </strong>Improving physical function in older adults necessitates adoption of evidence-based rehabilitation like HIR. Implementation strategies that target infrastructure, including leadership support and communication channels, inertia of current practice, and clinician perspectives of HIR complexity and patient compatibility may facilitate implementation. Identifying a champion and providing guidance for effective patient engagement appear to be key.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"62"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of organizational characteristics in intervention sustainment: findings from a quantitative analysis in 42 HIV testing clinics in Vietnam.","authors":"Sophia M Bartels, Minh X Nguyen, Trang T Nguyen, Ha V Tran, Teerada Sripaipan, Ngan T K Nguyen, Van Anh T Cao, Van Anh T Tran, Byron J Powell, Clare Barrington, Luz M Reyes, Le Minh Giang, Huong T T Phan, William C Miller, Vivian F Go","doi":"10.1186/s43058-025-00745-6","DOIUrl":"10.1186/s43058-025-00745-6","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based intervention (EBI) sustainment is one of public health's largest translational research problems. Fewer than half of public health EBIs are sustained long-term, and sustainment challenges are even more pressing in low and middle-income countries (LMICs). Organizational characteristics, including organizations' inner structures, culture, and climate, may play a key role in EBI sustainment. However, little quantitative research has examined these relationships, particularly in LMICs.</p><p><strong>Methods: </strong>In this observational study, we assessed the association between baseline organizational characteristics and EBI sustainment within a cluster randomized implementation trial in Vietnam testing strategies to scale-up Systems Navigation and Psychosocial Counseling (SNaP) for people who inject drugs (PWID) living with HIV across 42 HIV testing clinics. From the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, five baseline organizational characteristics were selected for investigation: 1) organizational readiness for implementing change; 2) implementation leadership; 3) implementation climate; 4) percent PWID; and 5) staff workload. Six to ten months post-study completion, clinic staff and leadership completed a survey that included the Provider Report of Sustainment Scale (PRESS), a measure of EBI sustainment across a clinic. We conducted clinic-level simple and multiple linear regression analyses to evaluate the association between organizational characteristics and sustainment.</p><p><strong>Results: </strong>218 participants (94% completion rate) completed the PRESS survey. All implementation scales had good individual-level internal consistency reliability. Clinics with high organizational readiness to change at baseline had significantly greater SNaP sustainment than clinics with low organizational readiness to change (ß = 1.91, p = 0.015). None of the other organizational characteristics were associated with sustainment, controlling for study arm.</p><p><strong>Conclusions: </strong>We identified the importance of organizational readiness for SNaP sustainment in Vietnam. This study adds to the evidence base around the relationship between organizational characteristics and HIV intervention sustainment and could inform the development of future sustainment strategies. We also identified several areas for organizational characteristic and sustainment measure advancement, including the need for pragmatic sustainment measures that also capture EBI adaptation. This research demonstrates that assessing clinics' organizational readiness pre-implementation and providing tailored support to those with low readiness scores could improve HIV intervention sustainment for key populations.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"60"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Consolidated Approach to Intervention Adaptation (CLARION): Developing and undertaking an empirically and theoretically driven intervention adaptation.","authors":"Lydia Ould Brahim, Sylvie D Lambert, Nancy Feeley, Jane McCusker, Dan Bilsker, Mark J Yaffe, Rosetta Antonacci, Stephanie Robins, John William Kayser, Christine Genest, Haida Paraskevopoulos, Jessica Blair, Andrea Laizner","doi":"10.1186/s43058-025-00731-y","DOIUrl":"10.1186/s43058-025-00731-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intervention adaptation, the deliberate modification of the design or delivery of interventions to a new context, is more resource efficient than de novo development. However, adaptation must be approached methodically, as some modifications, such as those to the core components, may compromise the intervention's initial efficacy. While adaptation frameworks have been published, none have been identified as more likely to result in successful adaptations. Further, frameworks lack the step-by-step details needed for operationalization. Therefore, the goal of this paper is to share our experience in addressing these methodological limitations in intervention adaptation. The objectives were to describe: 1) our development of a step-by-step, theoretically and empirically driven approach to intervention adaptation labelled the ConsoLidated AppRoach to Intervention adaptatiON (CLARION), 2) the application of CLARION in adapting a depression self-management intervention, 3) the facilitators and challenges encountered when using CLARION.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The development of CLARION was informed by the Medical Research Council guidance, the Method for Program Adaptation through Community Engagement (M-PACE), and a published scoping review identifying the key steps in existing adaptation frameworks. M-PACE was selected for its patient-oriented research principles, its application to a similar complex intervention, and for offering some of the specificity needed for execution. However, the scoping review indicated that M-PACE lacked three critical steps: selecting a candidate intervention, understanding its core components, and pre-testing the adapted intervention. These were added to form CLARION, which was structured in two stages: the first involves selecting an intervention, identifying core components, and deciding on modifications; the second stage solicits interest stakeholder feedback to assess the acceptability of the preliminary adapted intervention (pre-test).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Once CLARION was developed, it was put into action to adapt a depression self-management intervention. CLARION demonstrated several strengths: 1) clearly articulating core components before deciding on modifications, 2) mobilizing a diverse steering committee of experts, including patient partners and developers of the original intervention, which balanced input and efficiency, and 3) establishing committee decision-making rules prior to adjudication (specific criteria and 75% supermajority). Key challenges included defining the types of modifications requiring committee input, determining the extent of the committee's involvement, and prioritizing the presence of all committee members at meetings to avoid difficulties integrating incongruent feedback.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The development of CLARION contributes to best practices for intervention adaptation by identifying step-by-step guidance as wel","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"59"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a stakeholder selected implementation strategy package - fast tracking, provider re-training, and co-location - on PrEP implementation for pregnant women in antenatal care clinics in western Kenya.","authors":"Joseph Sila, Anjuli Dawn Wagner, Felix Abuna, Julia C Dettinger, Ben Odhiambo, Nancy Ngumbau, George Oketch, Enock Sifuna, Laurén Gómez, Sarah Hicks, Bryan J Weiner, Grace John-Stewart, John Kinuthia","doi":"10.1186/s43058-025-00746-5","DOIUrl":"https://doi.org/10.1186/s43058-025-00746-5","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) is recommended for HIV prevention in pregnant and postpartum women at substantial ongoing risk for HIV. In resource-limited settings, there exist gaps in the integration of PrEP into antenatal care.</p><p><strong>Methods: </strong>We conducted a difference-in-differences analytic approach (3 months pre- and 3 months post) between January 2022 and July 2022 in 8 facilities (4 intervention and 4 comparison) in western Kenya. During the 6-month period, we tested a combination of 2 stakeholder selected implementation strategies - retraining health providers and fast tracking PrEP clients- to improve PrEP delivery. All study facilities dispensed PrEP in the Maternal and Child health clinics (MCH). We evaluated absolute changes in: PrEP penetration, PrEP fidelity, client PrEP knowledge, client satisfaction, and client waiting and service times as outcomes specified a priori while PrEP offer and HIV testing were outcomes specified post hoc. We measured acceptability and appropriateness by providers of the implementation strategies using AIM and IAM respectively.</p><p><strong>Results: </strong>We observed statistically significant improvements in PrEP penetration and PrEP offer (p < 0.05) and non-significant improvements in fidelity. PrEP penetration increased 6 percent points (p = 0.002), PrEP offer increased nearly 6 percentage points (p = 0.002), and PrEP fidelity increased 4 percentage points (p = 0.202) in intervention vs comparison facilities. Client PrEP knowledge increased 0.45 out of 7 total points (p < 0.001) and PrEP screening increased 13 percentage points (p = 0.001). We observed no significant changes in service time (0.13-min increase; p = 0.249), waiting time (0.03-min decrease; p = 0.796), or client satisfaction (0.04/24 total point decrease; p = 0.849) in intervention vs comparison facilities. HIV testing did not significantly change (7 percentage point decrease, p = 0.305). The implementation strategy bundle was deemed appropriate and acceptable by the providers (appropriateness: 18.5/20; acceptability: 18.5/20). Overall, the implementation strategy bundle was associated with larger increases in implementation outcomes among women receiving a visit other than their first ANC visit, as well as among sites without stockouts of HIV test kits.</p><p><strong>Conclusions: </strong>A stakeholder-selected implementation strategy bundle that included retraining healthcare workers, fast tracking PrEP clients to reduce waiting time, and PrEP dispensing in MCH improved several implementation outcomes without significantly affecting waiting time or reducing service time.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"58"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between internal facilitation processes and implementation outcomes among hospitals participating in a quality improvement collaborative to reduce cesarean births: a mixed-methods embedded case study.","authors":"Jennifer A Callaghan-Koru, Rachel Blankstein Breman, Bonnie DiPietro, Loren Henderson, Geoffrey Curran","doi":"10.1186/s43058-025-00735-8","DOIUrl":"https://doi.org/10.1186/s43058-025-00735-8","url":null,"abstract":"<p><strong>Background: </strong>Quality improvement collaboratives (QICs) are a common strategy for implementing evidence-based practices; however, there is often variable performance between participating organizations. Few studies of QICs assess the internal facilitation (IF) processes engaged in by participating organizations, which may be key to understanding and enhancing the effectiveness of QICs as an implementation strategy. We examined IF processes among hospitals participating in Maryland's perinatal QIC to implement national guidelines for reducing primary cesarean births.</p><p><strong>Methods: </strong>This study followed a mixed-methods embedded case study design. We conducted qualitative interviews with internal implementation leaders at 21 QIC-participating hospitals using a guide informed by the iPARIHS and CFIR frameworks. Two investigators independently coded transcripts in Dedoose using a modified CFIR codebook including seven IF process codes adapted from published categorizations. The investigators also independently applied the CFIR rating system to rate each IF process as a barrier (-2, -1), facilitator (+ 1, + 2), neutral (0), or mixed (X), for each hospital. Final ratings were established through consensus discussions. Average ratings were calculated by hospital and process and charted alongside implementation outcomes from secondary data sources for identification of patterns.</p><p><strong>Results: </strong>Hospital leaders engaged in a variety of activities within each IF process. The average hospital rating across IF processes ranged from -1.1 to + 1.5. The IF process with the highest average rating was project management (average: 1.0; SD: 0.9), the lowest was planning (average: 0.5; SD: 1.0) and the most variable was providing individual support and accountability (average: 0.5; SD: 1.2). Negative ratings resulted from hospital teams not engaging in an IF process or the activities of hospital teams being insufficient to overcome related contextual barriers. Average IF process ratings were significantly higher among hospitals that implemented more than the median number of practice changes. Multiple contextual determinants influenced each IF process; work infrastructure and relational connections were the most frequent influences across IF processes.</p><p><strong>Conclusions: </strong>IF processes played an important role in determining implementation success at hospitals participating in a perinatal QIC. Monitoring and strengthening IF processes at participating organizations may enhance the effectiveness of QICs as an implementation strategy.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}