Using Implementation and Dissemination Concepts to Spread 21st-century Well-Child Care at a Health Maintenance Organization

Beck, Arne; Bergman, David A.; Rahm, Alanna Kulchak; Dearing, James W.; Glasgow, Russell E.

doi:10.7812/tpp/08-088

Cited by 16 publications

(19 citation statements)

References 25 publications

(21 reference statements)

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“…They were able to identify barriers to colorectal screening at the staff, provider, and patient levels through stakeholder interviews, and were able to implement a program that addressed these specific barriers. Similarly, Beck et al [ 12 ] used PRISM to assess barriers and facilitators in focus groups. As far as we know, our study is the first application of PRISM to assess context, barriers, and facilitators using data from such a wide variety of sources.…”

Section: Discussionmentioning

confidence: 99%

“…PRISM is ideal for guiding our multi-site implementation effort because it accounts for multi-level effects; it builds on several Implementation Science frameworks and can guide pre-implementation, implementation, and evaluation. Several studies show that the adoption, implementation, and sustainment of interventions are related to how well the intervention is integrated into the local context [ 12 – 16 ]. We will assess PRISM domains using convergent mixed methods, collecting both quantitative facility-level data, and qualitative data.…”

Section: Methodsmentioning

confidence: 99%

“…The dual goals of this project are to (1) improve transitions and reduce hospital readmissions for rural Veterans hospitalized at tertiary VA facilities, and (2) contribute to the field of implementation science through a robust application of the PRISM framework at every stage from pre-implementation contextual assessment, to implementation and adaptation, to evaluation. The PRISM framework has been used to assess site context in a number of studies [ 12 , 13 ], but to our knowledge, it has not been used to organize and integrate data from multiple sources or in an iterative manner to guide implementation and evaluation in successive waves. This work will address a gap in the literature on the use of PRISM to guide implementation.…”

Section: Introductionmentioning

confidence: 99%

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Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study

et al. 2017

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BackgroundAdapting promising health care interventions to local settings is a critical component in the dissemination and implementation process. The Veterans Health Administration (VHA) rural transitions nurse program (TNP) is a nurse-led, Veteran-centered intervention designed to improve transitional care for rural Veterans funded by VA national offices for dissemination to other VA sites serving a predominantly rural Veteran population. Here, we describe our novel approach to the implementation and evaluation = the TNP.MethodsThis is a controlled before and after study that assesses both implementation and intervention outcomes. During pre-implementation, we assessed site context using a mixed method approach with data from diverse sources including facility-level quantitative data, key informant and Veteran interviews, observations of the discharge process, and a group brainstorming activity. We used the Practical Robust Implementation and Sustainability Model (PRISM) to inform our inquiries, to integrate data from all sources, and to identify factors that may affect implementation. In the implementation phase, we will use internal and external facilitation, paired with audit and feedback, to encourage appropriate contextual adaptations. We will use a modified Stirman framework to document adaptations. During the evaluation phase, we will measure intervention and implementation outcomes at each site using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). We will conduct a difference-in-differences analysis with propensity-matched Veterans and VA facilities as a control. Our primary intervention outcome is 30-day readmission and Emergency Department visit rates. We will use our findings to develop an implementation toolkit that will inform the larger scale-up of the TNP across the VA.DiscussionThe use of PRISM to inform pre-implementation evaluation and synthesize data from multiple sources, coupled with internal and external facilitation, is a novel approach to engaging sites in adapting interventions while promoting fidelity to the intervention. Our application of PRISM to pre-implementation and midline evaluation, as well as documentation of adaptations, provides an opportunity to identify and address contextual factors that may impede or enhance implementation and sustainability of health interventions and inform dissemination.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study

et al. 2017

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“…Bergman et al and Beck et al describe this model in detail. 11,12 In brief, this system incorporates three improvements to the WCC visit: 1) the use of a Web-based, previsit assessment completed by the family that allows the practitioner to tailor the visit to the family needs; 2) the use of different visit types, eg, brief visits or e-visits that allow the clinician to modify resources and personnel based on the needs of the child; and 3) an extended visit for children with special health care needs. A key component of the HPWCC model is the Web-based tool, the Child Health and Development Interactive System (CHADIS) (www.childhealthcare.org/chadis).…”

Section: Introductionmentioning

confidence: 99%

A New Model of Well-Child Care: Implications for Resource Costs and Dissemination

Ritzwoller

Sukhanova²,

Beck³

et al. 2011

TPJ

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“…Tailored waiting room programs have been implemented in clinical settings for adults [33], and Internet tools have been provided to support walking in family medicine practices [34]. Applications of these systems in pediatric settings include using pre-visit assessments by parents to improve well-child visits [35, 36], to address overweight using tailored text messages [37], and to provide tailored injury information to parents [38]. …”

Section: Discussionmentioning

confidence: 99%

Reach of a kiosk-based pediatric injury prevention program

Weaver

Nansel

Williams

et al. 2011

Behav. Med. Pract. Policy Res.

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While controlled trials are important for determining the efficacy of public health programs, implementation studies are critical to guide the translation of efficacious programs to general practice. To implement an evidence-based injury prevention program and examine program use and completion rates in two implementation phases, Safe N′ Sound, an evidence-based program, was implemented in five pediatric clinics. Data on program use were collected from program files and patient census data. Program use averaged 12.1% of eligible patients during implementation and 9.5% during the continuation phase. Program completion averaged 9.7% and 6.5%, respectively. Findings from this study can inform the dissemination of evidence-based public health programs, particularly in practice-based clinical settings.

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Using Implementation and Dissemination Concepts to Spread 21st-century Well-Child Care at a Health Maintenance Organization

Cited by 16 publications

References 25 publications

Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study

Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study

A New Model of Well-Child Care: Implications for Resource Costs and Dissemination

Reach of a kiosk-based pediatric injury prevention program

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