Implementation science communications最新文献

{"title":"Factors influencing normalisation and sustainment of the Birmingham Symptom-specific Obstetric Triage System (BSOTS): a qualitative implementation evaluation study with UK maternity health professionals.","authors":"Nimarta Dharni, Agnieszka Latuszynska, Sophie-Anna Dann, Nina Johns, Graeme Currie, Sara Kenyon","doi":"10.1186/s43058-025-00710-3","DOIUrl":"10.1186/s43058-025-00710-3","url":null,"abstract":"<p><strong>Background: </strong>Maternity triage is the emergency portal to access maternity services for pregnant or newly postnatal women experiencing unexpected complications or concerns. Traditionally women were seen in the order in which they attended maternity services without appropriate organisational and clinical systems in place to prioritise the clinical urgency of the women presenting. The Birmingham Symptom-specific Obstetric Triage System (BSOTS) is a standardised triage system co-developed by clinicians and researchers to address this need. Since its inception in 2013, BSOTS is now the recommended triage system and has been widely implemented in the UK with international adoption also occurring. This study aimed to explore the factors influencing the normalisation and sustainment of BSOTS in UK maternity units.</p><p><strong>Methods: </strong>A qualitative evaluation study involving semi-structured interviews with 43 maternity professionals across 9 sites representing a range of implementation experiences (normalised n=3, partially normalised n=3, and probably not normalised n= 3). Participants were maternity triage staff of varying levels including midwives, obstetricians and senior leaders. Interviews were held virtually, and recorded and transcribed verbatim. Analysis was based on Normalisation Process Theory.</p><p><strong>Results: </strong>Contextual factors were key to influencing implementation and sustainment of BSOTS. In sites where BSOTS was normalised and integrated into routine practice, organisational and leadership buy-in helped mobilise support for other contextual factors required for implementation fidelity and success, including establishing a clear identity of the triage department, sufficient midwifery and obstetric staffing, appropriate space, a dedicated and protected core team, adequate equipment and resources. Accommodating these factors often meant complex system-level changes were required to implement BSOTS for which strategic intentions and organisational support were integral. In some cases, such support was facilitated by Care Quality Commission regulatory recommendations.</p><p><strong>Conclusions: </strong>Our study found successful implementation and normalisation of BSOTS was driven by contextual factors, particularly organisational buy-in and leadership support. While regulatory requirements enabled the prioritisation of triage within maternity services, our evaluation emphasised the importance of both leadership and frontline staff support for effective integration and sustainment. Evaluation findings were used to inform an implementation toolkit for clinical triage teams seeking to implement or reinvigorate BSOTS in their sites.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756371","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 and testing of an interactive evaluation tool: the Evaluating QUality and ImPlementation (EQUIP) Tool.","authors":"Laura McAlpine, Candace Ramjohn, Erin L Faught, Naomi Popeski, Eileen Keogh, Gabrielle L Zimmermann","doi":"10.1186/s43058-025-00715-y","DOIUrl":"10.1186/s43058-025-00715-y","url":null,"abstract":"<p><strong>Background: </strong>Evaluating implementation outcomes is gaining momentum in health service delivery organizations. Teams are increasingly recognizing the importance of capturing and learning from their implementation efforts, and Implementation Scientists have published extensively on implementation outcomes. However, Quality Improvement approaches and tools are more widely recognized and routinely used in healthcare to improve processes and outcomes. This article describes the development of an interactive online tool designed to help researchers and practitioners effectively design and develop appropriate evaluation plans that support the understanding of successful implementation.</p><p><strong>Methods: </strong>There were two main development phases. Phase 1, from January to October 2020, involved several design sessions with a small group of professionals leading implementation initiatives within the provincial health delivery system. This resulted in a testable prototype. Phase 2, from November 2020 to June 2021, focused on usability testing and interviews with a broader group of researchers and professionals leading implementation initiatives across the province.</p><p><strong>Results: </strong>The result is the EQUIP (Evaluating QUality and ImPlementation) Tool, an interactive online tool that integrates quality measures from the Alberta Quality Matrix for Health and implementation measures from widely used outcomes frameworks, such as the one developed by Proctor and colleagues and the RE-AIM planning and evaluation framework. The tool encourages users to explore implementation outcomes and quality dimensions from different perspectives and select questions and indicators relevant to their project.</p><p><strong>Conclusion: </strong>The EQUIP tool was designed and refined in collaboration with end users to create an accessible and practical online tool. This work addresses the call for greater integration of Quality Improvement and Implementation Science by combining approaches from both fields to strengthen evaluation processes within the health system.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756369","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":"Implementation strategies used in policy, systems, and environmental interventions addressing obesity-related outcomes in early childhood education settings: a systematic review.","authors":"Cody D Neshteruk, Courtney T Luecking, Chelsea L Kracht, Sarah Burkart, Emily M Melnick, Robert E Anderson, Hannah G Lane","doi":"10.1186/s43058-025-00718-9","DOIUrl":"10.1186/s43058-025-00718-9","url":null,"abstract":"<p><strong>Background: </strong>Policy, systems, and environmental (PSE) approaches, including those enacted in early childhood education (ECE) settings, can improve child health outcomes. The use of implementation strategies, or the ways in which these approaches are enacted across settings, may modify intervention impact. Therefore, the purpose of this review was to examine the implementation strategies used among interventions utilizing PSE approaches in the ECE setting.</p><p><strong>Methods: </strong>Seven databases including MEDLINE, PubMed, Web of Science, and EMBASE, were searched for interventions in ECE settings including children (0-6 years) that utilized ≥ 1 PSE approach. Eligible studies included either a child-level outcome (i.e., weight, physical activity, or diet) or an environmental outcome (i.e., nutrition and physical activity environment). Data extracted included study characteristics, description of the intervention, and description of the implementation of the intervention. Implementation strategies were coded using the School Implementation Strategies Translating ERIC Resources (SISTER) taxonomy. The Downs and Black checklist was completed to assess study quality.</p><p><strong>Results: </strong>One hundred and four studies representing 97 interventions were identified. Fourteen (14%) did not report any implementation strategies. Of the remaining 83 interventions reporting implementation strategies, the mean number of implementation strategies employed per intervention was 3.8 (± 2.3) (range 1-11). However, few interventions (5/83, 6%) clearly named and defined implementation strategies. Most implementation strategies came from the \"train and educate stakeholders\" SISTER domain (177/318, 56%), and the most frequently used implementation strategy was \"conduct educational meetings (50/83, 60%). Most studies were classified as good (59/104, 57%) or fair (40/104, 38%) quality.</p><p><strong>Conclusions: </strong>In this review, many interventions appeared to use multiple implementation strategies to support ECE PSE interventions, though few explicitly documented or described those strategies. These findings suggest that more precise documentation of implementation strategies is needed to enhance replication and scalability of ECE interventions.</p><p><strong>Registration: </strong>PROSPERO# CRD42022306670.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756374","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":"Bridging the gap: translating and simplifying CFIR 2.0 for French practitioners in implementation science.","authors":"Joanie Pellet, Sophie Pouzols, Valéry Ridde, Cédric Mabire","doi":"10.1186/s43058-025-00719-8","DOIUrl":"https://doi.org/10.1186/s43058-025-00719-8","url":null,"abstract":"<p><strong>Background: </strong>The Consolidated Framework for Implementation Research (CFIR) 2.0 is widely used in implementation projects but can be difficult for non-researchers to apply due to its complexity. While a French version of the original CFIR exists, CFIR 2.0 had not yet been translated. This study aimed to translate and simplify CFIR 2.0 for healthcare practitioners in French-speaking Switzerland to improve its accessibility and utility.</p><p><strong>Method: </strong>Using the Principles of Good Practice for Translation and Cultural Adaptation, the process included: (1) four independent forward translations, (2) reconciliation of simplified definitions, (3) online survey with 16 clinical nurse specialists to assess the content validity of the simplified definitions, (4) back translation, and (5) harmonization to finalize the French version. The content validity of each construct was assessed using the Content Validity Index (CVI), with further revisions based on feedback.</p><p><strong>Results: </strong>Most participants found the simplified definitions understandable, with an average score of 1.46 (where 1 is \"very easy to understand\" and 2 is \"easy to understand\"). Thirteen items with lower I-CVI scores (≤ 0.78) were revised. The overall S-CVI was 0.87, indicating high content validity. Minor discrepancies in the back translation were resolved.</p><p><strong>Conclusions: </strong>This study produced a French translation of CFIR 2.0 with simplified definitions tailored for healthcare practitioners. The high content validity and feedback underscore the need for contextually relevant adaptations to enhance the practical use of the CFIR framework. Further testing in diverse French-speaking contexts is necessary to refine the tool and broaden its applicability in real-world settings.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744436","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":"\"It's a priority\": a qualitative analysis of the implementation of a maternal equity safety bundle in Massachusetts.","authors":"Anna K Daoud, Elysia Larson, Tonia J Rhone, Claire R Conklin, Heather Olden, Kali Vitek, Howard Cabral, Eugene DeClercq, Ndidiamaka Amutah-Onukagha, Hafsatou Diop, Audra R Meadows","doi":"10.1186/s43058-025-00703-2","DOIUrl":"10.1186/s43058-025-00703-2","url":null,"abstract":"<p><strong>Background: </strong>Black-White inequities in severe maternal morbidity in the United States are extreme and growing. Maternal safety bundles (MSBs) have been associated with closing racial equity gaps in maternal health in some states. The objective of this study was to explore clinician perspective and experiences of implementing an Equity maternal safety bundle across five hospitals in Massachusetts to address inequities in perinatal care and birth outcomes.</p><p><strong>Methods: </strong>Focus group discussions and interviews were conducted in Fall 2022 and Fall 2023 (before and after Equity MSB implementation) among obstetric nurses, resident physicians, and attending physicians. Discussions were facilitated using a semi-structured guide developed using the Consolidated Framework for Implementation Research (CFIR). Transcripts were independently coded by two analysts using NVivo 14. A codebook was developed using CFIR for deductive coding. We added inductive codes as appropriate. We calculated Cohen's kappa coefficients to assess interrater reliability. Themes were generated through an iterative process and compared across study time points.</p><p><strong>Results: </strong>Fifteen clinicians participated at each time point with similar distributions across race, ethnicity, gender, and profession. Seven themes emerged from these interviews: 1) the importance of leadership support to prioritize equity, 2) a culture of equity as a facilitator for implementation, 3) the need for improved processes for self-reported race, ethnicity, and language data collection, stratification, and dissemination, 4) staff, time, and funding as necessary resources, 5) the need for an early focus on staff education, 6) existing siloes between physicians and nurses and exclusion of trainees as barriers to implementation, and 7) differences between an Equity-MSB and other MSBs.</p><p><strong>Conclusions: </strong>Leadership prioritization of equity and a culture of equity emerged as facilitators to successful implementation of elements of the Equity MSB. Challenges identified included resistance to change among colleagues, limited resources, and clinician siloes. When compared to previously implemented MSBs, participants found that leadership made this work a priority. As future hospital teams embark on implementing equity-focused action, these known facilitators and barriers should be considered and addressed during the pre- and early-implementation phases.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733460","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":"Implementation determinants of safer smoking supplies in U.S. syringe services programs.","authors":"William H Eger, Angel K Gomez, Kirstin Kielhold, Tyler S Bartholomew, Angela R Bazzi","doi":"10.1186/s43058-025-00714-z","DOIUrl":"10.1186/s43058-025-00714-z","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of smoking opioids and other unregulated drugs has increased across the United States (U.S.) since 2000. Improved access to safer smoking supplies may reduce the health consequences of inhalation while helping to engage more people who use drugs in syringe services programs (SSPs); however, the landscape of safer smoking supply implementation is understudied.</p><p><strong>Methods: </strong>From November 2023-January 2024, we surveyed representatives of U.S. SSPs to assess safer smoking supply implementation across contextual domains of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Descriptive statistics were used to describe determinants across the phases of safer smoking supply implementation. Poisson regression identified factors associated with implementation.</p><p><strong>Results: </strong>Among 118 organizations responding to the survey, most received state funding (83%), were community-based organizations (CBOs; 74%), and served urban jurisdictions (62%). The majority (67%) were already providing safer smoking supplies; 16% were exploring implementation and 11% were not. On average, safer smoking supply implementation occurred more recently than the provision of syringes (1-2 years ago vs. > 5 years ago), with participant request being the most common motivation for implementation (84%). Additional facilitators of safer smoking supply implementation were organizational prioritization (65%) and internal leadership support (57%). Factors significantly associated with safer smoking supply implementation included being from the Northeastern or Western regions (vs. the U.S. South), serving exurban communities, being a CBO, receiving foundation funding, receiving private donations from fundraising, and offering syringes and other injection alternatives (e.g., safer snorting supplies). Receiving federal funding, fear of external community opposition, internal leadership opposition, and respondent uncertainty about changing demand for safer smoking supplies (vs. perceiving that demand has not changed) were negatively associated with implementation.</p><p><strong>Conclusions: </strong>Determinants in the inner context, like organizational prioritization of safer smoking supplies and internal leadership support, may facilitate safer smoking supply implementation, while specific outer context factors (e.g., funding, regional policies) may inhibit implementation. Flexible policies and funding structures and further research to build and disseminate evidence on the benefits of safer smoking supplies are needed to expand the implementation and scale-up of this prevention service within U.S. SSPs.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712461","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":"Barriers and facilitators to HPV vaccination in rural South Carolina pharmacies: a qualitative investigation.","authors":"Abby Davies, Sarah Beth Tucker, Macie Goodman, Heather M Brandt, Tessa J Hastings","doi":"10.1186/s43058-025-00711-2","DOIUrl":"10.1186/s43058-025-00711-2","url":null,"abstract":"<p><strong>Introduction: </strong>As many as 14 million people contract a new case of HPV each year in the United States, with over 37,000 HPV cancers diagnosed each year. However, HPV vaccination coverage varies greatly with disparities by population and region. In rural areas, HPV vaccination rates for adolescents are significantly lower (12%) than for teens living in urban areas while HPV cancer rates are higher comparatively. Pharmacy-based vaccination services reduce accessibility barriers, as approximately 90% of Americans live within five miles of a community pharmacy. Unfortunately, implementation of HPV vaccination in community pharmacy settings remains low. Therefore, the objective of this study was to identify perceived barriers and facilitators to HPV vaccination services among South Carolina pharmacists.</p><p><strong>Methods: </strong>Qualitative interviews with community-based pharmacists practicing in rural South Carolina were conducted from August-December 2021. Community pharmacists practicing in areas with primary Rural-Urban Commuting Area (RUCA) codes of 4 and above were invited to participate in this study. Recruitment continued until point of saturation. Interviews were approximately 30 min in length and conducted using a semi-structured guide. Interview questions were open-ended and designed to elicit barriers and facilitators to administering the HPV vaccination in a pharmacy setting. All interviews were audio-recorded and transcribed. Transcripts were deductively coded using the Consolidated Framework for Implementation Research (CFIR), using NVivo to manage and analyze data.</p><p><strong>Results: </strong>Ten pharmacists participated in the qualitative interviews. Fourteen CFIR constructs were identified during qualitative analysis and interpretation. Applying the CFIR rating rules, seven constructs were found to have a strong influence (+ 2 or -2). Constructs with a strong positive influence, and indicated as facilitators, included \"patient needs and resources\" and \"cosmopolitanism\", while constructs with a strong negative influence, and indicated as barriers, included \"design quality and packaging\", \"cost\", \"available resources\", \"external policy and initiatives\", and \"innovation participants\".</p><p><strong>Conclusion: </strong>Multiple barriers and facilitators were identified as impacting HPV vaccination in rural South Carolina community pharmacies. Addressing these barriers may improve pharmacy-based HPV vaccination services, thereby improving access in rural communities. Findings from this study will be used to develop implementation strategies to increase administration of the HPV vaccine in pharmacy settings.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671870","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":"Combined use of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework with other implementation frameworks: a systematic review.","authors":"Sarah C Hunter, Samantha Morgillo, Bo Kim, Anna Bergström, Anna Ehrenberg, Ann Catrine Eldh, Lars Wallin, Alison L Kitson","doi":"10.1186/s43058-025-00704-1","DOIUrl":"10.1186/s43058-025-00704-1","url":null,"abstract":"<p><strong>Background: </strong>Appropriately and comprehensive applying implementation frameworks is one of the key challenges in implementation science resulting in increased use of multiple implementation frameworks within projects. This is particularly true for frameworks such as PARIHS/i-PARIHS. Therefore, this systematic review aimed to examine if and why the PARIHS/i-PARIHS framework has been applied in research with other implementation frameworks.</p><p><strong>Methods: </strong>We searched six databases from 2016 (the year following i-PARIHS' publication) to April 2024 and supplemented this with a citation search of the seminal i-PARIHS paper. We included studies that 1) were peer-reviewed with a protocol or empirical study design, 2) have applied the PARIHS or i-PARIHS framework for implementation planning, delivery, analysis, or evaluation and 3) also used at least one other implementation framework. Descriptive statistics were conducted to report on study characteristics and frequency for each implementation framework used with PARIHS/i-PARIHS. A qualitative, content analysis was used to analyse the answers to open-ended extraction questions.</p><p><strong>Results: </strong>Thirty-six articles met criteria for inclusion and included 16 protocols and 20 empirical articles (twelve intervention and eight cross-sectional studies). Thirty-four of the studies used one additional implementation framework and two studies used two additional implementation frameworks. In total, nine implementation frameworks were applied with PARIHS/i-PARIHS, including: 1) RE-AIM, 2) CFIR, 3) NPT, 4) REP, 5) TDF, 6), DSF, 7) KTA, 8) Stetler's Model, and 9) SIF. Thirty-four reported a rationale for using PARIHS/i-PARIHS and 34 reported a rationale for using the other implementation framework. Only eleven reported a rationale for using more than one implementation framework. Only three reported strengths of combining implementation frameworks.</p><p><strong>Conclusions: </strong>Overall, this review identified that implementation researchers are using PARIHS/i-PARIHS in combination with other implementation frameworks and providing little to no rationale for why. Use of multiple implementation frameworks without detailed rationales compromises our ability to evaluate mechanisms of effectiveness. Implementation researchers and practitioners need to be more explicit about their framework selection, detailing the complementary strengths of the frameworks that are being used in combination, including why using one is not sufficient.</p><p><strong>Trial registration: </strong>This systematic review was registered with PROSPERO: ID: 392147.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574963","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":"Evaluation of a notes-based rapid qualitative analysis method to facilitate implementation.","authors":"Rachel Brown, Sofia Cigarroa Kennedy, Elena Carranco Chávez, Jeriel Dumeng-Rodriguez, Danielle Cullen","doi":"10.1186/s43058-025-00709-w","DOIUrl":"10.1186/s43058-025-00709-w","url":null,"abstract":"<p><strong>Background: </strong>Qualitative methodologies offer a nuanced approach to understanding stakeholder perspectives, preferences, and context in implementation research. However, traditional qualitative data analysis can be time consuming and create barriers to responsive implementation of interventions. Rapid qualitative methods that yield timely, actionable results have emerged to expedite the evidence-to-practice gap, but often require all analysts to have implementation science expertise and resources for interview transcription. This study describes a novel rapid qualitative method to identify participant-driven social care recommendations in real time.</p><p><strong>Methods: </strong>Caregivers of pediatric patients were enrolled onsite at two primary care clinics and one emergency department affiliated with a large urban pediatric healthcare system. A semi-structured interview guide was developed using the Health Equity Implementation Framework and Integrated Behavioral Model in partnership with multidisciplinary implementation stakeholders. Telephone interviews explored 60 caregivers' experiences with and perceptions of receiving social resources from healthcare. For traditional analysis, NVivo12 was used to code the first 10 verbatim transcripts to generate themes in an integrated inductive/deductive approach. In the rapid approach, a summary notes template designed to capture implementation-related data was completed immediately following the same 10 interviews. A secondary analyst used the templates to create participant-level summaries and identify implementation-related themes. Themes found in each method were quantified and mapped onto each other using an analytic matrix to compare the number and consistency of themes.</p><p><strong>Results: </strong>Themes generated in both methods mapped consistently onto each other; 92.8% of themes found in traditional analysis were accounted for within our rapid method. The quantity of themes was similar between the two methods: the traditional approach generated 69 themes and 22 subthemes, while our rapid approach generated 72 themes and 21 subthemes.</p><p><strong>Conclusions: </strong>Our interview notes-based rapid qualitative method was successful in producing themes consistent with the traditional approach in both content and quantity. This approach is also pragmatic, as it does not require analysts to have deep implementation science expertise and saves transcription costs. By balancing rigor with time to actionable results, this rapid method provides a tool for implementation researchers to generate qualitative findings on an accelerated timeline to inform policy and practice.</p><p><strong>Clinical trial registration: </strong>This study was registered at ClinicalTrials.gov, #NCT05251311, https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT05251311 , on September 30, 2021.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544838","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":"Applying the major system change framework to evaluate implementation of rapid healthcare system change: a case study of COVID-19 remote home monitoring services.","authors":"Holly Walton, Nadia Crellin, Ian Litchfield, Chris Sherlaw-Johnson, Theo Georghiou, Efthalia Massou, Manbinder Sidhu, Sonila M Tomini, Lauren Herlitz, Jo Ellins, Pei Li Ng, Naomi J Fulop","doi":"10.1186/s43058-025-00707-y","DOIUrl":"10.1186/s43058-025-00707-y","url":null,"abstract":"<p><strong>Background: </strong>A framework to evaluate implementation of Major System Change (MSC) in healthcare has been developed and applied to implementation of longer-term system changes. This was the first study to apply the five domains of the MSC framework to rapid healthcare system change. We aimed to: i) evaluate implementation of rapid MSC, using England COVID-19 remote home monitoring services as a case study and ii) consider whether and how the MSC framework can be applied to rapid MSC.</p><p><strong>Methods: </strong>A mixed-methods rapid evaluation in England, across 28 primary and secondary healthcare sites (October 2020-November 2021; data collection: 4 months). We conducted 126 interviews (5 national leads, 59 staff, 62 patients/carers) and surveyed staff (n = 292) and patients/carers (n = 1069). Service providers completed cost surveys. Aggregated and patient-level national datasets were used to explore enrolment, service use and clinical outcomes. The MSC framework was applied retrospectively. Qualitative data were analysed thematically to explore key themes within each MSC framework domain. Descriptive statistics and multivariate analyses were used to analyse experience, costs, service use and clinical outcomes.</p><p><strong>Results: </strong>Decision to change/Decision on model: Service development happened concurrently: i) early local development motivated by urgent clinical need, ii) national rollout using standard operating procedures, and iii) local implementation and adaptation. Implementation approach: Services were tailored to local needs to consider patient, staff, organisational and resource factors. Implementation outcomes: Patient enrolment was low (59% services <10%). Service models and implementation approaches varied substantially. Intervention outcomes: No associations found between services and clinical outcomes. Patient and staff experiences were generally positive. However, barriers to delivery and engagement were found; with some groups finding it harder to engage.</p><p><strong>Conclusions: </strong>Low enrolment rates and substantial variation due to tailoring services to local contexts meant it was not possible to conclusively determine service effectiveness. Process outcomes indicated areas of improvement. The MSC framework can be used to analyse rapid MSC. Implementation and factors influencing implementation may differ to non-rapid contexts (e.g. less uniformity, more tailoring). Our mixed-methods approach could inform future evaluations of large-scale rapid and non-rapid MSC in a range of conditions and services internationally.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544815","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}