Implementation science communications最新文献

{"title":"Using Normalisation Process Theory to explore the contribution of stakeholder workshops to the development and refinement of a complex behavioural intervention: the STAMINA lifestyle intervention.","authors":"Sophie Reale, Rebecca R Turner, Liz Steed, Steph J C Taylor, Derek J Rosario, Liam Bourke, Dylan Morrissey, Aidan Q Innes, Eileen Sutton","doi":"10.1186/s43058-024-00629-1","DOIUrl":"10.1186/s43058-024-00629-1","url":null,"abstract":"<p><strong>Background: </strong>The National Institute for Health and Care Excellence (NICE) recommend that men with prostate cancer on androgen deprivation therapy (ADT) are offered twice weekly supervised aerobic and resistance exercise to address side effects of treatment. However, supervised exercise is not routinely offered in standard clinical practice. The STAMINA programme grant for applied research (PGfAR) has been designed to evaluate whether this recommendation can be delivered within standard NHS care. This paper describes how future implementation of NICE recommendations within the NHS was explored during complex intervention development to enable evaluation of a lifestyle intervention.</p><p><strong>Methods: </strong>Two stakeholder workshops were conducted to explore factors pertinent to future implementation of the STAMINA Lifestyle intervention (SLI). Normalisation Process Theory (NPT) provided the theoretical framework for discussion and analysis. Stakeholder workshop 1 focussed on intervention coherence and buy-in. Stakeholder workshop 2 explored barriers and facilitators for embedding SLI into the context of the NHS, with delivery partner Nuffield Health, in the future.</p><p><strong>Results: </strong>Workshops were attended by healthcare professionals (n = 16), exercise professionals (n = 17), members of public involved in PPI including patients (n = 12), health psychologists (n = 2), clinical commissioners (n = 4), cancer charities (n = 3), a cancer alliance (n = 1) and health economist (n = 1). Stakeholders agreed that professional training packages should emphasise the uniqueness of the SLI and underpinning theory and evidence (Coherence). To further engagement, the use of STAMINA champions and information about the delivery partner were recommended to enhance confidence and knowledge (Cognitive participation). Furthermore, a simple communication (Collective Action) and progress reporting system (Reflexive Monitoring) was suggested to fit into existing infrastructure within the NHS and community partner.</p><p><strong>Conclusions: </strong>Application of NPT within two stakeholder workshops enhanced complex intervention development. Context-specific strategies to support implementation of SLI within the context of a trial were proposed, sensed-checked, and considered acceptable. The organisational implications of embedding and sustaining the intervention in preparation for wider NHS roll-out were considered (if proven to be effective) and will be explored in the qualitative component of a process evaluation underpinned by NPT.</p><p><strong>Trial registration: </strong>(ISRCTN: 46385239 ). Registered on July 30, 2020.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121266","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":"Patient and clinic staff perspectives on the implementation of a long-acting injectable antiretroviral therapy program in an urban safety-net health system.","authors":"Afiba Manza-A Agovi, Caitlin T Thompson, Kevin J Craten, Esther Fasanmi, Meng Pan, Rohit P Ojha, Erika L Thompson","doi":"10.1186/s43058-024-00631-7","DOIUrl":"https://doi.org/10.1186/s43058-024-00631-7","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable cabotegravir plus rilpivirine (LAI CAB/RPV) has several potential benefits over daily oral formulations for HIV treatment, including the potential to facilitate long-term adherence and reduce pill fatigue. We aimed to assess facilitators of and barriers to LAI CAB/RPV implementation and delivery through the perspectives of physicians and clinical staff, and the experiences of LAI CAB/RPV use among people living with HIV (PLWH) at a Ryan-White supported safety-net clinic in North Texas.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with recruited clinic staff (physicians, nurses, and support staff) involved with LAI CAB/RPV implementation and PLWH who switched to LAI CAB/RPV and consented to participate in individual interviews. Data were collected from July to October 2023. Our interview guide was informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM), and Proctor Implementation Outcomes frameworks. Qualitative data were analyzed using a rapid qualitative analysis approach to summarize key themes.</p><p><strong>Results: </strong>We recruited and interviewed 15 PLWH who transitioned to LAI CAB/RPV and 11 clinic staff serving these patients. PLWH conveyed that emotional and informational support from family or a trusted clinician influenced their decision to switch to LAI CAB/RPV. PLWH also reported that injectable treatment was more effective, convenient, and acceptable than oral antiretroviral therapy. Clinic staff and physicians reported that staff training, pharmacist-led medication switches, flexible appointments, refrigeration space and designated room for injection delivery facilitated implementation. Clinic staff cited medication costs, understaffing, insurance prior authorization requirements, and lack of medication access through state drug assistance programs as critical barriers.</p><p><strong>Conclusions: </strong>Our study offers insights into real-world experiences with LAI usage from the patient perspective and identifies potential strategies to promote LAI CAB/RPV uptake. The barriers to and facilitators of LAI CAB/RPV program implementation reported by clinic staff in our study may be useful for informing strategies to optimize LAI CAB/RPV programs.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115698","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":"A qualitative study identifying implementation strategies using the i-PARIHS framework to increase access to pre-exposure prophylaxis at federally qualified health centers in Mississippi.","authors":"Trisha Arnold, Laura Whiteley, Kayla K Giorlando, Andrew P Barnett, Ariana M Albanese, Avery Leigland, Courtney Sims-Gomillia, A Rani Elwy, Precious Patrick Edet, Demetra M Lewis, James B Brock, Larry K Brown","doi":"10.1186/s43058-024-00632-6","DOIUrl":"10.1186/s43058-024-00632-6","url":null,"abstract":"<p><strong>Background: </strong>Mississippi (MS) experiences disproportionally high rates of new HIV infections and limited availability of pre-exposure prophylaxis (PrEP). Federally Qualified Health Centers (FQHCs) are poised to increase access to PrEP. However, little is known about the implementation strategies needed to successfully integrate PrEP services into FQHCs in MS.</p><p><strong>Purpose: </strong>The study had two objectives: identify barriers and facilitators to PrEP use and to develop tailored implementation strategies for FQHCs.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 19 staff and 17 PrEP-eligible patients in MS FQHCs between April 2021 and March 2022. The interview was guided by the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework which covered PrEP facilitators and barriers. Interviews were coded according to the i-PARIHS domains of context, innovation, and recipients, followed by thematic analysis of these codes. Identified implementation strategies were presented to 9 FQHC staff for feedback.</p><p><strong>Results: </strong>Data suggested that PrEP use at FQHCs is influenced by patient and clinic staff knowledge with higher levels of knowledge reflecting more PrEP use. Perceived side effects are the most significant barrier to PrEP use for patients, but participants also identified several other barriers including low HIV risk perception and untrained providers. Despite these barriers, patients also expressed a strong motivation to protect themselves, their partners, and their communities from HIV. Implementation strategies included education and provider training which were perceived as acceptable and appropriate.</p><p><strong>Conclusions: </strong>Though patients are motivated to increase protection against HIV, multiple barriers threaten uptake of PrEP within FQHCs in MS. Educating patients and providers, as well as training providers, are promising implementation strategies to overcome these barriers.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"92"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094267","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":"A mixed-methods approach to assessing implementers' readiness to adopt digital health interventions (RADHI).","authors":"Dennis H Li, Alithia Zamantakis, Juan P Zapata, Elizabeth C Danielson, Rana Saber, Nanette Benbow, Justin D Smith, Gregory Swann, Kathryn Macapagal, Brian Mustanski","doi":"10.1186/s43058-024-00628-2","DOIUrl":"10.1186/s43058-024-00628-2","url":null,"abstract":"<p><strong>Background: </strong>Despite being the primary setting for HIV prevention among men who have sex with men (MSM) since the start of the epidemic, community-based organizations (CBOs) struggle to reach this historically stigmatized and largely hidden population with face-to-face interventions. HIV researchers have readily turned to the internet to deliver critical HIV education to this group, with evidence of high effectiveness and acceptability across studies. However, implementation outside of research contexts has been limited and not well studied. We aimed to assess HIV CBOs' readiness to adopt digital health interventions and identify contextual factors that may contribute to differing levels of readiness.</p><p><strong>Methods: </strong>We recruited 22 CBOs across the US through a pragmatic request-for-proposals process to deliver Keep It Up! (KIU!), an evidence-based eHealth HIV prevention program. We used mixed methods to examine CBO readiness to adopt digital health interventions (RADHI). Before implementation, CBO staff completed a 5-item RADHI scale (scored 0-4) that demonstrated concurrent and predictive validity. We interviewed CBO staff using semi-structured questions guided by the Consolidated Framework for Implementation Research and compared RADHI score groups on determinants identified from the interviews.</p><p><strong>Results: </strong>Eighty-five staff (range = 1-10 per CBO) completed the RADHI. On average, CBOs reported moderate-to-great readiness (2.74) to adopt KIU!. High RADHI CBOs thought KIU! was a top priority and an innovative program complementary to their existing approaches for their clients. Low RADHI CBOs expressed concerns that KIU! could be a cultural mismatch for their clients, was lower priority than existing programs and services, relied on clients' own motivation, and might not be suitable for clients with disabilities. Value, appeal, and limitations did not differ by RADHI group.</p><p><strong>Conclusions: </strong>While HIV CBOs are excited for the opportunities and advantages of digital interventions, additional pre-implementation and implementation support may be needed to increase perceived value and usability for different client populations. Addressing these limitations is critical to effective digital prevention interventions for HIV and other domains such as mental health, chronic disease management, and transitions in care. Future research can utilize our novel, validated measure of CBOs' readiness to adopt digital health interventions.</p><p><strong>Trial registration: </strong>NCT03896776, clinicaltrials.gov, 1 April 2019.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"91"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082821","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":"Promoting the implementation of a computer-tailored physical activity intervention: development and feasibility testing of an implementation intervention.","authors":"Denise A Peels, Janet M Boekhout, Femke van Nassau, Lilian Lechner, Catherine A W Bolman, Brenda A J Berendsen","doi":"10.1186/s43058-024-00622-8","DOIUrl":"10.1186/s43058-024-00622-8","url":null,"abstract":"<p><strong>Background: </strong>Although there are many proven effective physical activity (PA) interventions for older adults, implementation in a real world setting is often limited. This study describes the systematic development of a multifaceted implementation intervention targeting the implementation of an evidence-based computer-tailored PA intervention and evaluates its use and feasibility.</p><p><strong>Methods: </strong>The implementation intervention was developed following the Intervention Mapping (IM) protocol, supplemented with insights from implementation science literature. The implementation intervention targets the municipal healthcare policy advisors, as an important implementation stakeholder in Dutch healthcare system. The feasibility of the implementation intervention was studied among these stakeholders using a pretest-posttest design within 8 municipal healthcare settings. Quantitative questionnaires were used to assess task performance (i.e. achievement of performance objectives), and utilization of implementation strategies (as part of the intervention). Furthermore, changes in implementation determinants were studied by gathering quantitative data before, during and after applying the implementation intervention within a one-year period. Additionally, semi-structured interviews with stakeholders assessed their considerations regarding the feasibility of the implementation intervention.</p><p><strong>Results: </strong>A multi-faceted implementation intervention was developed in which implementation strategies (e.g. funding, educational materials, meetings, building a coalition) were selected to target the most relevant identified implementation determinants. Most implementation strategies were used as intended. Execution of performance objectives for adoption and implementation was relatively high (75-100%). Maintenance objectives were executed to a lesser degree (13-63%). No positive changes in implementation determinants were found. None of the stakeholders decided to continue implementation of the PA intervention further, mainly due to the unforeseen amount of labour and the disappointing reach of end-users.</p><p><strong>Conclusion: </strong>The current study highlights the importance of a thorough feasibility study in addition to the use of IM. Although feasibility results may have demonstrated that stakeholders broadly accepted the implementation intervention, implementation determinants did not change favorably, and stakeholders had no plans to continue the PA intervention. Yet, choices made during the development of the implementation intervention (i.e. the operationalization of Implementation Mapping) might not have been optimal. The current study describes important lessons learned when developing an implementation intervention, and provides recommendations for developers of future implementation interventions.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"90"},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006085","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":"Specifying behavioural and strategy components of de-implementation efforts targeting low-value prescribing practices in secondary health care.","authors":"Jennifer Dunsmore, Eilidh Duncan, Sara MacLennan, James N'Dow, Steven MacLennan","doi":"10.1186/s43058-024-00624-6","DOIUrl":"10.1186/s43058-024-00624-6","url":null,"abstract":"<p><strong>Background: </strong>/Aims De-implementation, including the removal or reduction of unnecessary or inappropriate prescribing, is crucial to ensure patients receive appropriate evidence-based health care. The utilization of de-implementation efforts is contingent on the quality of strategy reporting. To further understand effective ways to de-implement medical practices, specification of behavioural targets and components of de-implementation strategies are required. This paper aims to critically analyse how well the behavioural targets and strategy components, in studies that focused on de-implementing unnecessary or inappropriate prescribing in secondary healthcare settings, were reported.</p><p><strong>Methods: </strong>A supplementary analysis of studies included in a recently published review of de-implementation studies was conducted. Article text was coded verbatim to two established specification frameworks. Behavioural components were coded deductively to the five elements of the Action, Actor, Context, Target, Time (AACTT) framework. Strategy components were mapped to the nine elements of the Proctor's 'measuring implementation strategies' framework.</p><p><strong>Results: </strong>The behavioural components of low-value prescribing, as coded to the AACTT framework, were generally specified well. However, the Actor and Time components were often vague or not well reported. Specification of strategy components, as coded to the Proctor framework, were less well reported. Proctor's Actor, Action target: specifying targets, Dose and Justification elements were not well reported or varied in the amount of detail offered. We also offer suggestions of additional specifications to make, such as the 'interactions' participants have with a strategy.</p><p><strong>Conclusion: </strong>Specification of behavioural targets and components of de-implementation strategies for prescribing practices can be accommodated by the AACTT and Proctor frameworks when used in conjunction. These essential details are required to understand, replicate and successfully de-implement unnecessary or inappropriate prescribing. In general, standardisation in the reporting quality of these components is required to replicate any de-implementation efforts.</p><p><strong>Trial registration: </strong>Not registered.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"88"},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903815","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":"Correction: Implementing evidence-based practices to improve primary care for high-risk patients: study protocol for the VA high-RIsk VETerans (RIVET) type III effectiveness-implementation trial.","authors":"Elvira E Jimenez, Ann-Marie Rosland, Susan E Stockdale, Ashok Reddy, Michelle S Wong, Natasha Torrence, Alexis Huynh, Evelyn T Chang","doi":"10.1186/s43058-024-00623-7","DOIUrl":"10.1186/s43058-024-00623-7","url":null,"abstract":"","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"86"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876887","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":"Understanding barriers and facilitators to integrated HIV and hypertension care in South Africa.","authors":"Leslie C M Johnson, Suha H Khan, Mohammed K Ali, Karla I Galaviz, Fatima Waseem, Claudia E Ordóñez, Mark J Siedner, Athini Nyatela, Vincent C Marconi, Samanta T Lalla-Edward","doi":"10.1186/s43058-024-00625-5","DOIUrl":"10.1186/s43058-024-00625-5","url":null,"abstract":"<p><strong>Background: </strong>The burden of hypertension among people with HIV is high, particularly in low-and middle-income countries, yet gaps in hypertension screening and care in these settings persist. This study aimed to identify facilitators of and barriers to hypertension screening, treatment, and management among people with HIV in primary care clinics in Johannesburg, South Africa. Additionally, different stakeholder groups were included to identify discordant perceptions.</p><p><strong>Methods: </strong>Using a cross-sectional study design, data were collected via interviews (n = 53) with people with HIV and hypertension and clinic managers and focus group discussions (n = 9) with clinic staff. A qualitative framework analysis approach guided by COM-B and the Theoretical Domains Framework were used to identify and compare determinants of hypertension care across stakeholder groups.</p><p><strong>Results: </strong>Data from clinic staff and managers generated three themes characterizing facilitators of and barriers to the adoption and implementation of hypertension screening and treatment: 1) clinics have limited structural and operational capacity to support the implementation of integrated care models, 2) education and training on chronic care guidelines is inconsistent and often lacking across clinics, and 3) clinicians have the goal of enhancing chronic care within their clinics but first need to advocate for health system characteristics that will sustainably support integrated care. Patient data generated three themes characterizing existing facilitators of and barriers to clinic attendance and chronic disease self-management: 1) the threat of hypertension-related morbidity and mortality as a motivator for lifestyle change, 2) the emotional toll of clinic's logistical, staff, and resource challenges, and 3) hypertension self-management as a patchwork of informational and support sources. The main barriers to hypertension screening, treatment, and management were related to environmental resources and context (i.e., lack of enabling resources and siloed flow of clinic operations) and patients' knowledge and emotions (i.e., lack of awareness about hypertension risk, fear, and frustration). Clinical actors and patients differed in perceived need to prioritize HIV versus hypertension care.</p><p><strong>Conclusions: </strong>The convergence of multi-stakeholder data highlight key areas for improvement, where tailored implementation strategies targeting motivations of clinic staff and capacity of patients may address challenges to hypertension screening, treatment, and management recognized across groups.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"87"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876888","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":"Learning Health System to rapidly improve the implementation of a school physical activity policy.","authors":"Cassandra Lane, Nicole Nathan, John Wiggers, Alix Hall, Adam Shoesmith, Adrian Bauman, Daniel Groombridge, Rachel Sutherland, Luke Wolfenden","doi":"10.1186/s43058-024-00619-3","DOIUrl":"10.1186/s43058-024-00619-3","url":null,"abstract":"<p><strong>Background: </strong>Learning Health Systems (LHS) - characterised by cycles of evidence generation and application - are increasingly recognised for their potential to improve public health interventions and optimise health impacts; however there is little evidence of their application in the context of public health practice. Here, we describe how an Australian public health unit applied a LHS approach to successfully improve a model of support for implementation of a school-based physical activity policy.</p><p><strong>Methods: </strong>This body of work was undertaken in the context of a strong research-practice partnership. Core LHS capabilities included: i) partnerships and stakeholder engagement; ii) workforce development and learning health communities; iii) multi-disciplinary scientific expertise; iv) practice data collection and management system; v) evidence surveillance and synthesis; and vi) governance and organisational processes of decision making. Three cycles of data generation and application were used. Within each cycle, randomised controlled trials conducted in NSW primary schools were used to generate data on the support model's effectiveness for improving schools' implementation of a government physical activity policy, its delivery costs, and process measures such as adoption and acceptability. Each type of data were analysed independently, synthesised, and then presented to a multi-disciplinary team of researchers and practitioners, in consult with stakeholders, leading to collaborative decisions for incremental improvements to the support model.</p><p><strong>Results: </strong>Cycle 1 tested the first version of the support model (composed of five implementation strategies targeting identified barriers of policy implementation) and showed the model's feasibility and efficacy for improving schools' policy implementation. Data-informed changes were made to enhance impact, including the addition of three implementation strategies to address outstanding barriers. Cycle 2 (now, testing a package of eight implementation strategies) established the model's effectiveness and cost-effectiveness for improving school's policy implementation. Data-informed changes were made to reduce delivery costs, specifically adapting the costliest strategies to reduce in-person contact from external support personnel. Cycle 3 showed that the adaptations minimised the relative cost of delivery without adversely impacting on the effect.</p><p><strong>Conclusions: </strong>Through this process, we identified an effective, cost-effective, acceptable and scalable policy implementation support model for service delivery. This provides important information to inform or support LHS approaches for other agencies seeking to optimise the health impact of evidence-based interventions.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"85"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861846","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":"Development of the Technical Assistance Engagement Scale: a modified Delphi study.","authors":"Victoria C Scott, Jasmine Temple, Zara Jillani","doi":"10.1186/s43058-024-00618-4","DOIUrl":"10.1186/s43058-024-00618-4","url":null,"abstract":"<p><strong>Background: </strong>Technical assistance (TA) is a tailored approach to capacity building that is commonly used to support implementation of evidence-based interventions. Despite its widespread applications, measurement tools for assessing critical components of TA are scant. In particular, the field lacks an expert-informed measure for examining relationship quality between TA providers and recipients. TA relationships are central to TA and significantly associated with program implementation outcomes. The current study seeks to address the gap in TA measurement tools by providing a scale for assessing TA relationships.</p><p><strong>Methods: </strong>We utilized a modified Delphi approach involving two rounds of Delphi surveys and a panel discussion with TA experts to garner feedback and consensus on the domains and items that compose the TA Engagement Scale.</p><p><strong>Results: </strong>TA experts represented various U.S. organizations and TA roles (e.g., provider, recipient, researcher) with 25 respondents in the first survey and 26 respondents in the second survey. The modified Delphi process resulted in a scale composed of six domains and 22 items relevant and important to TA relationships between providers and recipients.</p><p><strong>Conclusion: </strong>The TA Engagement Scale is a formative evaluation tool intended to offer TA providers the ability to identify strengths and areas for growth in the provider-recipient relationship and to communicate about ongoing needs. As a standard measurement tool, it lends a step toward more systematic collection of TA data, the ability to generate a more coherent body of TA evidence, and enables comparisons of TA relationships across settings.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"5 1","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794188","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}