Using Implementation Mapping to Develop Implementation Strategies for the Delivery of a Cancer Prevention and Control Phone Navigation Program: A Collaboration With 2-1-1

BackgroundA large and growing percentage of medically underserved groups receive care at federally qualified health centers (FQHCs). Care coordination is an evidence-based approach to address disparities in healthcare services. A partnered FQHC established a care coordination model to improve receipt and quality of healthcare for patients most at risk for poor health outcomes. This care coordination model emphasizes identification and support of behavioral health needs (e.g., depression, anxiety) and two evidence-based behavioral health programs needs were selected for implementation within the context of this care coordination model. Implementation Mapping is a systematic process for specifying the implementation strategies and outcomes. The current case study describes the application of Implementation Mapping to inform the selection and testing of implementation strategies to improve implementation of two behavioral health programs in a Care Coordination Program at a partnered FQHC.MethodsWe applied Implementation Mapping to inform the development, selection and testing of implementation strategies to improve the implementation of two evidence-based behavioral health programs within a care coordination program at a partnered FQHC.ResultsResults are presented by Implementation Mapping task, from Task 1 through Task 5. We also describe the integration of additional implementation frameworks (The Consolidated Framework for Implementation Research, Health Equity Implementation Framework) within the Implementation Mapping process to inform determinant identification, performance and change objectives development, design and tailoring of implementation strategies and protocols, and resulting evaluation of implementation outcomes.ConclusionsThe current project is an example of real-world application of Implementation Mapping methodology to improve care outcomes for a high priority population that is generalizable to other settings utilizing similar care models and health equity endeavors. Such case studies are critical to advance our understanding and application of innovative implementation science methods such as Implementation Mapping.

Section: Discussionsupporting

confidence: 85%

Applying Implementation Mapping to Expand a Care Coordination Program at a Federally Qualified Health Center

Dickson

Holt

Arredondo

2022

“…To select, adapt, or develop the readiness building strategies that would achieve the readiness building outcome, implementation teams identified theoretical methods known to target the determinants identified (and associated with the specific change objectives within the matrices as outlined in Task 2). Theoretical methods are a key component of the mechanisms of action for influencing determinants, while practical applications of these methods, described here as readiness building strategies, operationalize them in a way that is consistent with the population and setting ( 10 , 21 ). After methods to influence change in the determinants were identified, each implementation team developed specific strategies to operationalize these methods and ensured that the strategies developed were feasible to implement.…”

Section: Resultsmentioning

confidence: 99%

Using Implementation Mapping to Build Organizational Readiness

Watson¹,

Hernandez

Kolodny-Goetz³

et al. 2022

Self Cite

Organizational readiness is essential for high-quality implementation of innovations (programs, policies, practices, or processes). The R = MC2 heuristic describes three readiness components necessary for implementation—the general functioning of the organization (general capacities), the ability to deliver a particular innovation (innovation-specific capacities), and the motivation to implement the innovation. In this article, we describe how we used the Readiness Building System (RBS) for assessing, prioritizing, and improving readiness and Implementation Mapping (IM), a systematic process for planning implementation strategies, to build organizational readiness for implementation of sexual assault prevention evidence-based interventions (EBIs). While RBS provides an overarching approach for assessing and prioritizing readiness constructs (according to the R = MC2 heuristic; Readiness = Motivation x general Capacity × innovation specific Capacity), it does not provide specific guidance on the development and/or selection and tailoring of strategies to improve readiness. We used the five IM tasks to identify and prioritize specific readiness goals and develop readiness-building strategies to improve subcomponents described in the R = MC2 heuristic. This article illustrates how IM can be used synergistically with the RBS in applied contexts to plan implementation strategies that will improve organizational readiness and implementation outcomes. Specifically, we provide an example of using these two frameworks as part of the process of building organizational readiness for implementation of sexual assault prevention EBIs.

“…Second, it can be challenging to find a shared language that can be used by and with all stakeholders in an Implementation Mapping process. This is important for building a constructive work relationship ( 3 ), mutual understanding, and trust. Although collaboration and communication competences are seen as essential for leading successful implementation projects, these are rarely targeted by implementation science training ( 24 ) and more practical guidance is needed on how to create successful participatory implementation processes.…”

Section: Discussionmentioning

confidence: 99%

“…As a participatory approach, it involves engaging intervention users and implementers in the respective setting. Implementation Mapping has been used for prospectively planning implementation in a variety of fields, such as cancer prevention and control ( 3 ) and chronic pain management ( 4 ). The process follows five steps: identifying stakeholders and conducting needs assessments, identifying implementation outcomes and determinants, designing implementation strategies, creating implementation protocols, and evaluating implementation outcomes ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…Benefits of Implementation Mapping include a more transparent selection of implementation strategies that makes it easier to replicate selection processes in similar studies ( 3 ). Accordingly, reasons for choosing implementation strategies as well as these strategies' potential mechanisms of action are more explicitly documented ( 4 ), which is particularly helpful for presenting the results of the Implementation Mapping process to involved stakeholders ( 3 ). Working closely with and understanding the needs of stakeholders is another key element of Implementation Mapping ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Modified Implementation Mapping Methodology for Evaluating and Learning From Existing Implementation

Schultes

Albers

Caci

et al. 2022

When empirically supported interventions are implemented in real-world practice settings, the process of how these interventions are implemented is highly relevant for their potential success. Implementation Mapping is a method that provides step-by-step guidance for systematically designing implementation processes that fit the respective intervention and context. It includes needs assessments among relevant stakeholders, the identification of implementation outcomes and determinants, the selection and design of appropriate implementation strategies, the production of implementation protocols and an implementation outcome evaluation. Implementation Mapping is generally conceptualized as a tool to prospectively guide implementation. However, many implementation efforts build on previous or ongoing implementation efforts, i.e., “existing implementation.” Learnings from existing implementation may offer insights critical to the success of further implementation activities. In this article, we present a modified Implementation Mapping methodology to be applied when evaluating existing implementation. We illustrate the methodology using the example of evaluating ongoing organized colorectal cancer screening programs in Switzerland. Through this example, we describe how we identify relevant stakeholders, implementation determinants and outcomes as well as currently employed implementation strategies. Moreover, we describe how we compare the types of strategies that are part of existing implementation efforts with those that implementation science would suggest as being suited to address identified implementation determinants. The results can be used for assessing the current state of implementation outcomes, refining ongoing implementation strategies, and informing future implementation efforts.