Implementation science communications最新文献

{"title":"Let us be heard: critical analysis and debate of collaborative research approaches used in implementation science research with equity-deserving populations.","authors":"Sarah Madeline Gallant, Cynthia Mann, Britney Benoit, Megan Aston, Janet Curran, Christine Cassidy","doi":"10.1186/s43058-025-00695-z","DOIUrl":"10.1186/s43058-025-00695-z","url":null,"abstract":"<p><strong>Background: </strong>Implementation Science research completed with equity-deserving populations is not well understood or explored. The current opioid epidemic challenges healthcare systems to improve existing practices through implementation of evidence-based interventions. Pregnant persons diagnosed with opioid use disorder (OUD) is an equity-deserving population that continues to experience stigmatization within our healthcare system. Efforts are being made to implement novel approaches to care for this population; however, the implementation research continues to leave the voices of pregnant persons unheard, compounding the existing stigma and marginalization experienced.</p><p><strong>Methods: </strong>This debate paper highlights a specific case that explores the implementation of the Eat, Sleep, Console (ESC) model of care, a function-based empowerment model used to guide the care for pregnant persons diagnosed with OUD and their infants. We establish our debate within the conceptual discussion of Nguyen and colleagues (2020), and critically analyze the collaborative research approaches, engaged scholarship, Mode 2 research, co-production, participatory research and IKT, within the context of engaging equity-deserving populations in research. We completed a literature search in CINAHL, Google Scholar, PubMed and Embase using keywords including collaborative research, engagement, equity-deserving, marginalized populations, birthparents, substance use and opioid use disorder with Boolean operators, to support our debate.</p><p><strong>Discussion: </strong>IKT and Community Based Participatory Action Research (CBPR) were deemed the most aligned approaches within the case, and boast many similarities; however, they are fundamentally distinct. Although CBPR's intentional methods to address social injustices are essential to consider in research with pregnant persons diagnosed with OUD, IKT aligned best within the implementation science inquiry due to its neutral philosophical underpinning and congruent aims in exploring complex implementation science inquiries. A fundamental gap was noted in IKT's intentional considerations to empowerment and equitable engagement of equity-deserving populations in research; therefore, we proposed informing an IKT approach with Edelman's Trauma and Resilience Informed Research Principles and Practice (TRIRPP) Framework.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043893","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":"Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study.","authors":"Amelia DeFosset, Breanna Deutsch-Williams, Mysha Wynn, Katrina Blunt, Scott Rosas, Mary Wolfe McKinley, Brian Ellerby, Shirley McFarlin, Veena Reddy, Giselle Corbie, Gaurav Dave","doi":"10.1186/s43058-024-00692-8","DOIUrl":"10.1186/s43058-024-00692-8","url":null,"abstract":"<p><strong>Background: </strong>African Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To understand how to implement and sustain evidence-based CVD programs at scale, we must explore the perspectives of organizations serving rural African American communities and situate findings within foundational Implementation Science frameworks.</p><p><strong>Methods: </strong>This study used group concept mapping (GCM) to elicit and synthesize stakeholder perspectives into an action-focused conceptual model depicting factors influencing implementation of evidence-based CVD programs. Representatives of community-based, faith, and healthcare organizations serving African Americans in five rural North Carolina counties were recruited via purposive sampling techniques. Participants (total n = 31) completed three activities: 1) brainstorming in response to an open-ended prompt (n = 31); 2) sorting brainstorm data into wider concepts and rating each in terms of relative importance and feasibility (n = 26); and 3) collaborative interpretation and refinement of the concept map (n = 19). Multivariate statistical analysis was used to generate a concept map. Absolute pattern matches comparing ratings of the relative importance and feasibility of each factor were generated and depicted via ladder graphs.</p><p><strong>Results: </strong>The final concept map included five factors: Accessibility, Community and Social Factors, Education and Training, Financial/Resource Development, and Organization Capacity and Staffing. There was high agreement (r = .98) between ratings of importance and feasibility. Education and Training, both within organizations and the wider community, was rated as the most important and feasible factor and Financial/Resource Development was the least important and feasible.</p><p><strong>Conclusions: </strong>The concept map emphasizes aspects of organizations (inner setting), their surrounding community (outer setting), and individual stakeholders (participants, implementers) as influencing implementation of evidence-based CVD prevention and management programs in rural African American communities. The nature of the intervention or implementation processes were de-emphasized. Organizations in rural African American communities may feel equipped to implement a range of evidence-based programs, provided strategies address the contextual and structural barriers that impede their success. Group concept mapping helped distill and prioritize initial leverage points for action in our project catchment area by facilitating a community-engaged process of data generation and interpretation.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017539","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":"Designing an intervention to improve cognitive evaluations in primary care.","authors":"Kyra S O'Brien, Kristin Harkins, MaryAnne Peifer, Melanie Kleid, Cameron Coykendall, Judy Shea, Jason Karlawish, Robert E Burke","doi":"10.1186/s43058-025-00693-1","DOIUrl":"10.1186/s43058-025-00693-1","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis is crucial to the optimal management of patients with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias. For some patients, early detection of cognitive impairment enables access to disease-modifying therapies. For all patients, it allows access to psychosocial supports. Patients typically first present their concerns about their cognition to a primary care provider, but in this setting, cognitive impairment is commonly underdiagnosed. There is also high variability in how cognitive evaluations are performed. We sought to understand barriers to and facilitators of cognitive evaluations in primary care, map barriers to implementation strategies, and gain consensus from stakeholders on possible strategies to improve dementia diagnosis in primary care.</p><p><strong>Methods: </strong>Semi-structured interviews conducted with primary care providers (PCPs). We used the Consolidated Framework for Implementation Research to inform our question guide and analysis, and incorporated chart-stimulated recall - using actual patients who had cognitive complaints who had presented to these providers - to understand clinicians' medical decision-making processes. These data were used to map identified barriers and facilitators to targeted implementation strategies. Then, this candidate list of strategies was presented to an expert stakeholder panel including clinicians and clinical operations specialists. Through a modified Delphi process, the list was narrowed to select the most promising strategies to incorporate in an intervention to improve cognitive evaluations in primary care.</p><p><strong>Results: </strong>Twenty PCPs were interviewed and mentioned barriers included lack of expertise to perform or interpret an assessment, time pressures, lack of incentives, competing priorities, lack of decision-making supports, and limited access to dementia specialists. Facilitators included the presence of an informant or caregiver and having additional staff to conduct cognitive testing. Implementation mapping resulted in a list of 15 candidate strategies. Using the modified Delphi process, these were narrowed to six.</p><p><strong>Conclusions: </strong>We used a rigorous process to identify barriers to and facilitators of cognitive assessments in primary care, identify promising implementation strategies to address these barriers, and obtain the feedback of front-line users on these strategies. This holds substantial promise for improving cognitive assessments in primary care in future implementation trials.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017455","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":"Use of implementation logic models in the Quadruple Aim QUERI: conceptualization and evolution.","authors":"Russell E Glasgow, Marina S McCreight, Brianne Morgan, Heidi Sjoberg, Anne Hale, Lexus Ujano-De Motta, Lauren McKown, Rachael Kenney, Heather Gilmartin, Christine D Jones, Joseph Frank, Borsika A Rabin, Catherine Battaglia","doi":"10.1186/s43058-024-00678-6","DOIUrl":"10.1186/s43058-024-00678-6","url":null,"abstract":"<p><strong>Background: </strong>Implementation strategies are essential to deliver evidence-based programs that align with local context, resources, priorities, and preferences. However, it is not always clear how specific strategies are selected (vs. others) and strategies are not always operationalized clearly, distinctly, and dynamically. Implementation logic models provide one useful way to conceptualize the role and selection of implementation strategies, plan evaluation of their intended impacts on implementation and effectiveness outcomes, and to communicate key aspects of a project.</p><p><strong>Methods: </strong>This paper describes our initial plans, experiences, and lessons learned from applying implementation logic models in the Quadruple Aim Quality Enhancement Research Initiative (QUERI) a large multi-study program funded by the Veterans Health Administration (VA). We began with two primary implementation strategies based on our earlier work (i.e., Iterative RE-AIM and Relational Facilitation) that were applied across three different health outcomes studies.</p><p><strong>Results: </strong>Our implementation strategies evolved over time, and new strategies were added. This evolution and reasons for changes are summarized and illustrated with the resulting logic models, both for the overall Quadruple Aim QUERI and the three specific projects. We found that implementation strategies are often not discrete, and their delivery and adaptation is dynamic and should be guided by emerging data and evolving context. Review of logic models across projects was an efficient and useful approach for understanding similarities and differences across projects.</p><p><strong>Conclusions: </strong>Implementation logic models are helpful for clarifying key objectives and issues for both study teams and implementation partners. There are challenges in logic model construction and presentation when multiple strategies are employed, and when strategies change over time. We recommend presentation of both original and periodically updated project models and provide recommendations for future use of implementation logic models.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017492","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":"Scaling up of parenting support to prevent violence against children in Tanzania: insights from policymakers and service providers.","authors":"Sabine van Tuyll van Serooskereken Rakotomalala, Kija Nyalali, Joyce Wamoyi, Onduru Gervas Onduru, Gerry Mshana, F Marijn Stok, Mara A Yerkes, John B F De Wit","doi":"10.1186/s43058-024-00684-8","DOIUrl":"10.1186/s43058-024-00684-8","url":null,"abstract":"<p><strong>Background: </strong>Evidence shows that parenting behaviours, including the use of violent discipline, can be changed through programmatic interventions. This study seeks to examine how policymakers and service providers in Tanzania perceive the provision of parenting support as a strategy to prevent violence against children and what the enabling and hindering factors are for the scale-up of existing evidence-based parenting supports. It does this by applying Daly's analytical framework for parenting support.</p><p><strong>Methods: </strong>Qualitative research was undertaken, with interviews conducted with 20 key informants consisting of purposively sampled policymakers and service providers. The interview data were analysed using inductive and deductive coding and analysis.</p><p><strong>Results: </strong>The most prominent enabling factors noted for the scale-up of parenting support interventions in Tanzania include the existing supportive political commitment, the interventions currently on offer at the programmatic level, and the perceived understanding of Tanzanian caregivers of the importance of parenting and, thereby, a willingness to change. Current factors hindering the scale-up include the lack of a common understanding of what evidence-based parenting programmes entail, inadequate provision of human and financial capital to implement the programmes using community resources and deeply engrained social norms around adultism and gender.</p><p><strong>Conclusion: </strong>Daly's analytical framework allowed us to examine barriers and facilitators to scale-up the provision of parenting support to prevent violence against children, based on the viewpoints of policymakers and service providers. Understanding these barriers and facilitators will allow Tanzanian policymakers and service providers to further close the gap between the policies and the actual implementation of evidence-based parenting support programmes aimed at preventing violence against children.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980909","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 implementation of a patient safety bundle for pregnancy-related severe hypertension in 3 North Carolina outpatient clinics: a qualitative study.","authors":"Aparna G Kachoria, Hiba Fatima, Alexandra F Lightfoot, Linda Tawfik, Joan Healy, Asia Carter, Narges Farahi, E Nicole Teal, Joumana K Haidar, Herbert B Peterson, M Kathryn Menard","doi":"10.1186/s43058-024-00685-7","DOIUrl":"10.1186/s43058-024-00685-7","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy related hypertension is a leading cause of preventable maternal morbidity and mortality in the US, with consistently higher rates affecting racial minorities. Many complications are preventable with timely treatment, in alignment with the Alliance for Innovation on Maternal Health's Patient Safety Bundle (\"Bundle\"). The Bundle has been implemented successfully in inpatient settings, but 30% of preeclampsia-related morbidity occurs in outpatient settings in North Carolina. To address this, we have integrated community engagement and implementation science approaches to identify facilitators and barriers to Bundle implementation, which supports its adaptation for outpatient settings and identifies implementation strategies to be tested in a subsequent study.</p><p><strong>Methods: </strong>Eleven key informant interviews were conducted across three clinics to assess the implementation needs for effectively utilizing the Bundle. The interview guide was created using the Consolidated Framework for Implementation Research domains to identify facilitators and barriers to implementation. Additionally, three focus group discussions with patient participants were conducted to understand lived experiences and perceptions of respectful care. A coalition of community partners, patients, providers, those with lived experience, and the research team reviewed materials from the formative study design to dissemination and planning for future study.</p><p><strong>Results: </strong>Barriers included inadequate provider-patient interaction time, patients' lack of transportation to access care, limited protocols to inform/assess/treat/escalate patients, and workforce capacity (staff training and turnover). Facilitators included staff recognition of the importance of treating preeclampsia, champion buy-in of the Bundle's ability to improve outcomes, co-location of pharmacies for immediate treatment, and staff capacity. Respectful care principles were repeatedly identified as a facilitator for Bundle implementation, specifically for patient awareness of preeclampsia complications and treatment adherence.</p><p><strong>Conclusions: </strong>Findings highlight the importance of community-engaged approaches. Further, clinic staff regarded Bundle implementation as crucial for the outpatient setting. Identified barriers suggest that strategies should address systemic social supports (i.e., transportation, childcare) and improve access to and use of home blood pressure monitoring. Identified facilitators support improving communication, increasing clinic champion engagement, enabling systems for identifying at-risk patients, and training staff on accurate blood pressure measurement. Successful Bundle implementation requires addressing systemic barriers to delivering respectful care, such as limited time with patients.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959852","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":"Attitudes toward scale-up of an Intensive Combination Approach to Rollback the Epidemic in Nigerian adolescents (iCARE) intervention for youth in Nigeria: results of a mixed methods early-implementation study.","authors":"Arthi Kozhumam, Revika Singh, Oche Agbaji, Adedotun Adetunji, Bopo Taiwo, Olayinka Omigbodun, Kehinde Kuti, Agatha David, Sulaimon Akanmu, Folashade Adekambi, Akinsegun Akinbami, Bibilola Oladeji, Babafemi Taiwo, Lisa M Kuhns, Ogochukwu Okonkwor, Baiba Berzins, Amy K Johnson, Titilope Badru, Patrick Janulis, Olubusuyi M Adewumi, Marbella Cervantes, Olutosin Awolude, Robert Garofalo, Aima A Ahonkhai, Lisa R Hirschhorn","doi":"10.1186/s43058-024-00671-z","DOIUrl":"https://doi.org/10.1186/s43058-024-00671-z","url":null,"abstract":"<p><strong>Background: </strong>Youth living with HIV (YLH) are disproportionately impacted by HIV with poor outcomes along the entire HIV care continuum. In a 2020-2022 pilot study, iCARE Nigeria, successfully tested a combination intervention incorporating mobile health technology and peer navigation to: 1) improve testing and linkage to HIV care for young men, especially young men who have sex with men (YMSM) and 2) improve medication adherence and treatment outcomes for YLH. The intervention was scaled up to 5 sites in 3 Nigerian cities. Implementation research was used to understand site perspectives on feasibility, readiness and potential facilitators and barriers soon after scale-up commencement.</p><p><strong>Methods: </strong>An explanatory mixed-methods implementation study was conducted, including quantitative surveys on adoption and reach among peer navigators (PNs) and other study staff (55 testing, 172 treatment), and interviews and focus group discussions with PNs and other study staff in both intervention groups (n = 31). Data were analyzed using descriptive statistics (quantitative) and directed content analysis using the Consolidated Framework for Implementation Research and RE-AIM (qualitative).</p><p><strong>Results: </strong>Early into scale-up, PNs and other study staff in the testing and treatment interventions reported high readiness, adoption, feasibility, and appropriateness. Facilitating factors and strategies across both interventions, included supportive institutional culture, ongoing supportive supervision, provision of a manual and training, relevant PN working experiences, communication methods designed to ensure anonymity of targeted youth (testing) or confidentiality (treatment), and access to cellular data and internet. Facilitators specific to each intervention were also identified including PN knowledge of the MSM community, using multiple social media platforms for outreach (testing) and problem-solving by PN and staff to respond to client needs (treatment). Barriers in both interventions included client financial and transportation challenges, and societal stigma. Intervention-specific barriers included legal limitations for MSM and few YMSM friendly clinics (testing), limited client financial resources and cell-phone access (treatment).</p><p><strong>Conclusions: </strong>Implementers of the initial scale-up of both components of the iCARE Nigeria intervention reported high readiness and adoption, supported by implementation strategies and facilitating factors including intervention design. These results are important for informing future work to scale-out iCARE and similar interventions to new settings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov number, NCT04950153, retrospectively registered July 6, 2021, https:// clinicaltrials.gov/.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959845","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":"Education strategies are the most commonly used in pediatric rehabilitation implementation research: a scoping review.","authors":"Sahar Ghahramani, Sophia C Larson, Allison J L'Hotta, Kelly M Harris, Kim Lipsey, Elvin H Geng, Lisa A Juckett, Catherine R Hoyt","doi":"10.1186/s43058-024-00690-w","DOIUrl":"10.1186/s43058-024-00690-w","url":null,"abstract":"<p><strong>Background: </strong>Approximately one in six children has a disability, and effective, evidence-based rehabilitation can ameliorate the impact of these conditions over the lifespan. However, implementing interventions in real-world settings remains a challenge. This scoping review aimed to summarize the characteristics, implementation strategies, and outcomes of implementation studies in pediatric rehabilitation.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed/MEDLINE, EMBASE, CINAHL, SCOPUS, and Web of Science from the database inception to December 2, 2022. Studies testing implementation strategies in pediatric rehabilitation interventions were included. Data extracted included study characteristics (e.g., country, intervention type, field of rehabilitation), implementation strategies characterized using the Expert Recommendations for Implementing Change taxonomy, and outcomes based on the Implementation Outcomes Framework.</p><p><strong>Results: </strong>Of the 11,740 studies identified, 44 met the inclusion criteria. Most studies were conducted in the United States (n = 15, 34%) or Canada (n = 10, 23%) and used a mixed-methods design (n = 13, 30%). Interventions primarily targeted motor skills (n = 19, 43%) and were conducted in outpatient settings (n = 14, 32%) or homes (n = 11, 23%). The most commonly used implementation strategies were \"train and educate key informant\" (n = 21, 48%) and \"use evaluative/iterative strategies\" (n = 19, 43%). Feasibility (n = 19, 43%) and acceptability (n = 16, 36%) were the most frequently targeted implementation outcomes.</p><p><strong>Conclusions: </strong>Reporting implementation strategies and outcomes in pediatric rehabilitation studies is limited and highly variable. Most strategies focused on developing and sharing educational materials, while administrative and systems-level interventions were largely absent. Standardized documentation of implementation strategies and outcomes could advance the field's understanding of the effective development of interventions designed for implementation, encouraging faster uptake of effective interventions.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959762","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":"Developing archetypes for key roles in a pragmatic trial: implementing human-centered design to promote advance care planning in primary care.","authors":"Martha Abshire Saylor, Danny Scerpella, Margo Chapin, Anushka Jajodia, Amrutha J Kadali, Jessica L Colburn, Valerie Cotter, Jennifer L Wolff","doi":"10.1186/s43058-024-00683-9","DOIUrl":"https://doi.org/10.1186/s43058-024-00683-9","url":null,"abstract":"<p><strong>Background: </strong>Archetypes are representations of a group of people with shared behaviors, attitudes, and characteristics. The design and use of archetypes have potential application to increase partnership and support when embedding and scaling interventions but methodological approaches have not been developed.</p><p><strong>Objective: </strong>To describe the methodology of designing archetypes for use in a pragmatic trial of advance care planning in the primary care context, SHARING Choices ((NCT04819191). We present resulting archetypes representing three key roles (primary care champion, advance care planning facilitator, and patient) in our pragmatic trial.</p><p><strong>Methods: </strong>Our process for developing archetypes involved 4 steps: 1) Identify roles for archetype development, 2) Identify Shareholders and Data Sources for Archetype Development, 3) Generate unique archetypes and their distinguishing traits, and 4) Iteratively refine archetypes through exposure, scrutiny, and shareholder input. We also developed a process map to communicate our methodology.</p><p><strong>Results: </strong>We created 6 distinct archetypes for the primary care champion role, 5 archetypes for the advance care planning facilitator role and 6 archetypes for the patient role. For each archetype we described strengths, challenges, prevailing emotions, and successful approaches to collaboration (e.g., \"what works for me\"). Unique opportunities for synergy between archetypes (such as with facilitator and champion) and potential challenges between archetypes (such as for facilitator and patient) suggest ways to improve training and support of key roles.</p><p><strong>Discussion: </strong>Our process for creating archetypes for use in implementation research was iterative and informative in discussion of implementation with shareholders. We expect this methodology to be useful for anticipating and analyzing many aspects of implementation.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959846","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":"Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial.","authors":"Christopher M Fleming, Hannah G Calvert, Lindsey Turner","doi":"10.1186/s43058-024-00691-9","DOIUrl":"https://doi.org/10.1186/s43058-024-00691-9","url":null,"abstract":"<p><strong>Background: </strong>Rural School Support Strategies (RS3) is a bundle of implementation supports (including training, technical assistance, and a virtual learning collaborative) designed for the scale-up of universal prevention initiatives. This study addresses mechanisms of action, exploring whether positive effects of RS3 on implementation fidelity are attributable to improvements in functioning of school implementation teams, and increases in organizational readiness.</p><p><strong>Methods: </strong>Data are from a cluster-randomized hybrid Type 3 implementation-effectiveness trial of RS3 among rural Idaho schools implementing Positive Behavioral Interventions and Supports (PBIS). Forty public K-12 schools in Idaho, located in rural areas or townships, were recruited for the trial and were equally randomized to either the basic supports condition, including standard trainings, or to the RS3 condition. Condition was not masked. The mechanistic aims were hypothesized prior to the trial and tested with survey data from individuals on each school's implementation team (n = 205). Surveys were collected in spring 2019 and 2020 regarding organizational readiness and team functioning. The outcome measure was PBIS implementation fidelity, measured by school teams during the summers of 2019 and 2020 using the Tiered Fidelity Inventory. School-level path models tested the effect of RS3 on implementation fidelity, controlling for baseline, school grade level, and school location. Multilevel (2-1-2) mediation models tested the degree to which individual team members' perceptions of organizational readiness and team functioning mediated the relationship between school-level experimental condition and fidelity, controlling for the team members' role.</p><p><strong>Results: </strong>Schools receiving RS3 reported significantly greater implementation fidelity, although effects were slightly reduced (b = 8.40, p = .056, 95% CI [-0.22,17.01], β = 0.54) after inclusion of baseline and demographic controls. Models indicated a significant indirect effect of RS3 on fidelity through increased team productivity (b = 6.30, SE = 2.63, p = .017, MC 95% CI [0.83,13.86], β = 0.21), and effects through organizational readiness, change commitment, team culture, and team goal setting.</p><p><strong>Conclusions: </strong>External supports may improve implementation of universal prevention initiatives in rural schools through improvements in readiness and fostering teaming in organizations.</p><p><strong>Trial registration: </strong>This research was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959767","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}