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Carrandi A, Hu Y, McGill K, Wayland S, Karger S, Maple M. Operationalizing the Consolidated Framework for Implementation Research to build and support the lived experience workforce in direct health service provision. Health Expect 2024; 27:e14035. [PMID: 38567878 PMCID: PMC10989156 DOI: 10.1111/hex.14035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 02/27/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The involvement of people with lived experience (LEX) workers in the development, design, and delivery of integrated health services seeks to improve service user engagement and health outcomes and reduce healthcare gaps. Yet, LEX workers report feeling undervalued and having limited influence on service delivery. There is a need for systematic improvements in how LEX workforces are engaged and supported to ensure the LEX workforce can fully contribute to integrated systems of care. OBJECTIVE This study aimed to operationalize the Consolidated Framework for Implementation Research (CFIR) using a rigorous scoping review methodology and co-creation process, so it could be used by health services seeking to build and strengthen their LEX workforce. SEARCH STRATEGY A systematic literature search of four databases was undertaken to identify peer-reviewed studies published between 2016 and 2022 providing evidence of the inclusion of LEX workers in direct health service provision. DATA EXTRACTION AND SYNTHESIS A descriptive-analytical method was used to map current evidence of LEX workers onto the CFIR. Then, co-creation sessions with LEX workers (n = 4) and their counterparts-nonpeer workers (n = 2)-further clarified the structural policies and strategies that allow people with LEX to actively participate in the provision and enhancement of integrated health service delivery. MAIN RESULTS Essential components underpinning the successful integration of LEX roles included: the capacity to engage in a co-creation process with individuals with LEX before the implementation of the role or intervention; and enhanced representation of LEX across organizational structures. DISCUSSION AND CONCLUSION The adapted CFIR for LEX workers (CFIR-LEX) that was developed as a result of this work clarifies contextual components that support the successful integration of LEX roles into the development, design, and delivery of integrated health services. Further work must be done to operationalize the framework in a local context and to better understand the ongoing application of the framework in a health setting. PATIENT OR PUBLIC CONTRIBUTION People with LEX were involved in the operationalization of the CFIR, including contributing their expertise to the domain adaptations that were relevant to the LEX workforce.
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Affiliation(s)
- Alayna Carrandi
- Social Work, School of HealthUniversity of New EnglandArmidaleAustralia
- School of Public Health and Preventive Medicine, Department of Epidemiology & Preventative MedicineMonash UniversityMelbourneAustralia
| | - Yanan Hu
- Social Work, School of HealthUniversity of New EnglandArmidaleAustralia
- Women's Health Economics and Value Based Care, Monash Centre for Health and Research and ImplementationMonash UniversityClaytonAustralia
| | - Katherine McGill
- Social Work, School of HealthUniversity of New EnglandArmidaleAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleAustralia
- Healthy Minds, Hunter Medical Research InstituteNewcastleAustralia
- Mental Health‐Research, Evaluation and Dissemination (MH‐READ), Hunter New England Local Health DistrictNewcastleAustralia
| | - Sarah Wayland
- Social Work, School of HealthUniversity of New EnglandArmidaleAustralia
| | - Shae Karger
- Social Work, School of HealthUniversity of New EnglandArmidaleAustralia
- Women's Health Economics and Value Based Care, Monash Centre for Health and Research and ImplementationMonash UniversityClaytonAustralia
| | - Myfanwy Maple
- Social Work, School of HealthUniversity of New EnglandArmidaleAustralia
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Garver-Apgar CE, Morris CM, Pavlik J, Lenartz T, Hamm M. Peer-Facilitated Tobacco Cessation in a Prison Setting: A Proof of Concept Study. Tob Use Insights 2023; 16:1179173X231168511. [PMID: 37051590 PMCID: PMC10084529 DOI: 10.1177/1179173x231168511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background Despite the vast human and economic costs associated with tobacco use among U.S. inmates, smoking remains a largely ignored public health epidemic. Incarcerated individuals smoke at 3 to 4 times the rate of the general population and face tobacco-related health disparities. Purpose This paper reports results from a single arm, pre/post pilot study designed to test the feasibility and initial effectiveness of an inmate-administered group tobacco cessation intervention within a men’s pre-release program run by the Arizona Department of Corrections. Methods Corrections staff and inmate peer mentors were trained in the DIMENSIONS: Tobacco Free Program, a manualized 6-session tobacco cessation group curriculum. Group sessions used evidence-based interventions for assisting inmates develop skills to live tobacco and nicotine free. In 2019-2020, 39 men who reported tobacco use voluntarily participated in one of three cessation groups. Wilcoxen signed-rank tests evaluated changes across group sessions in frequency of tobacco use and attitudes about nicotine-free living post release. Results Most participants attended all six group sessions (79%) and made one or more quit attempts (78%). Overall, 24% of the sample reported quitting tobacco, and significant reductions in tobacco use were reported after only two sessions. Participants further reported significant positive changes in knowledge, plans, support, and confidence to live tobacco-free lives post-release. Conclusions To our knowledge, this is the first study to demonstrate that, with minimal investment, implementation of an evidence-based, peer-led tobacco free program is feasible and effective within an incarcerated population uniquely vulnerable to the burden of tobacco.
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Affiliation(s)
| | - Chad M. Morris
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jim Pavlik
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Hyde J, Byrne T, Petrakis BA, Yakovchenko V, Kim B, Fincke G, Bolton R, Visher C, Blue-Howells J, Drainoni ML, McInnes DK. Enhancing community integration after incarceration: findings from a prospective study of an intensive peer support intervention for veterans with an historical comparison group. HEALTH & JUSTICE 2022; 10:33. [PMID: 36348203 PMCID: PMC9644600 DOI: 10.1186/s40352-022-00195-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The transition to the community after incarceration presents challenges for returning citizens, including the immediate need to secure housing, employment, and income. Additionally, health care is essential for this population due to high rates of chronic physical health and mental health problems and substance use disorders. There is growing recognition of the need for interventions that support returning citizens as they navigate community reintegration while simultaneously tending to physical and behavioral health needs. We developed and pilot tested a peer support intervention designed to provide social, emotional, and logistic support and promote linkage and engagement in healthcare for returning citizens. We tested the intervention with US military veterans in Massachusetts who were being released from prison and jail. Outcomes related to linkage to and engagement in healthcare were evaluated using an historical comparison group. Engagement in peer support, housing status, and reincarceration rates were monitored for the intervention group. RESULTS There were 43 veterans in the intervention group, and 36 in the historical comparison group. For linkage to primary care within 90 days of release, there were no statistically significant differences between the intervention and comparison groups (58% versus 67%). Intervention participants were significantly more likely to receive substance use treatment than the comparison group (86% versus 19%, p < .0001) and the mean monthly substance use visits was greater in the intervention group (0.96 versus 0.34, p < .007). Engagement in mental health services was greater for the intervention group than the comparison group (93% versus 64%, p < .003). There were no significant differences between groups for emergency department use and hospitalization. At the end of the study period, the majority of intervention participants who had been released for over a year were living in permanent housing (84%). Recidivism among the was low, with 7% re-arrested during the study period. CONCLUSIONS Augmenting reentry support through intensive peer support appears to have substantial benefits for veterans in terms of engaging them in health care and contributing to their longer-term stability, including housing and recidivism. Flexible reentry support such as this intervention may be well suited to meet the widely varying needs of returning citizens.
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Affiliation(s)
- Justeen Hyde
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 200 Springs Road, MS 152, Bldg. 70, Rm 285, Bedford, Bedford, MA, 01730, USA.
- General Internal Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Thomas Byrne
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 200 Springs Road, MS 152, Bldg. 70, Rm 285, Bedford, Bedford, MA, 01730, USA
- School of Social Work, Boston University, Boston, MA, USA
| | - Beth Ann Petrakis
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 200 Springs Road, MS 152, Bldg. 70, Rm 285, Bedford, Bedford, MA, 01730, USA
| | - Vera Yakovchenko
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Bo Kim
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, USA
| | - Graeme Fincke
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 200 Springs Road, MS 152, Bldg. 70, Rm 285, Bedford, Bedford, MA, 01730, USA
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Rendelle Bolton
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 200 Springs Road, MS 152, Bldg. 70, Rm 285, Bedford, Bedford, MA, 01730, USA
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Christy Visher
- Center for Drug & Health Studies, Department of Sociology and Criminal Justice, University of Delaware, Wilmington, DE, USA
| | - Jessica Blue-Howells
- VA Healthcare for Re-Entry Veterans, U.S. Department of Veteran Affairs, Washington, USA
| | - Mari-Lynn Drainoni
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA, USA
- Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA
| | - D Keith McInnes
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 200 Springs Road, MS 152, Bldg. 70, Rm 285, Bedford, Bedford, MA, 01730, USA
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA, USA
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An Update of Peer Support/Peer Provided Services Underlying Processes, Benefits, and Critical Ingredients. Psychiatr Q 2022; 93:571-586. [PMID: 35179660 PMCID: PMC8855026 DOI: 10.1007/s11126-022-09971-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 01/20/2023]
Abstract
The purpose of this article is to delineate the current state-of-the-knowledge of peer support following the framework employed in the 2004 article (Solomon, Psychiatr Rehabil J. 2004;27(4):392-401 1). A scoping literature was conducted and included articles from 1980 to present. Since 2004, major growth and advancements in peer support have occurred from the development of new specializations to training, certification, reimbursement mechanisms, competency standards and fidelity assessment. Peer support is now a service offered across the world and considered an indispensable mental health service. As the field continues to evolve and develop, peer support is emerging as a standard of practice throughout various, diverse settings and shows potential to impact clinical outcomes for service users throughout the globe. While these efforts have enhanced the professionalism of the peer workforce, hopefully this has enhanced the positive elements of these services and not diluted them.
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Abstract
LEARNING OBJECTIVE After participating in this activity, learners should be better able to:• Assess characteristics of forensic assertive community treatment programs. ABSTRACT Forensic assertive community treatment (FACT) has emerged internationally as an intervention strategy for people with serious mental disorders who are involved with the criminal justice system. Studies to date have shown marked variability, however, in FACT program design and operation. Based upon a literature review and relevant experience, the authors present their perspective on the essential elements of FACT. Given that FACT is an adaptation of the evidence-based assertive community treatment (ACT) model, it is recommended that FACT programs maintain a high-fidelity ACT component. FACT programs should also have both mental health and criminal justice admission criteria because service recipients are involved in both service systems. For optimal effectiveness, FACT team clinicians must partner with criminal justice agencies that provide community-based supervision to their patients. Prospective FACT enrollees should receive a clear explanation of the program, including how their respective mental health and criminal justice service providers will work collaboratively with them to prevent incarceration. FACT programs should also use risk/need assessment to inform treatment planning, evidence-based mental health and community correctional practices to promote both wellness and public safety, and shared training to promote effective collaboration. Additional elements to consider include housing, medical care, and transitional services. These elements are presented and discussed, including a rationale and evidence to support each component. The article concludes with introduction of a FACT fidelity scale, the Rochester Forensic Assertive Community Treatment Scale (R-FACTS). By operationalizing essential FACT elements, the R-FACTS is designed to support FACT program development, implementation, and dissemination in a more consistent and measurable manner.
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Adams WE, Lincoln AK. Barriers to and Facilitators of Implementing Peer Support Services for Criminal Justice-Involved Individuals. Psychiatr Serv 2021; 72:626-632. [PMID: 33730877 DOI: 10.1176/appi.ps.201900627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study sought to examine perceived barriers to and facilitators of the adoption, implementation, and sustainability of community-based mental health peer support services for criminal justice-involved individuals, also known as "forensic peer support" (FPS). METHODS Qualitative interviews were conducted with stakeholders (N=14) and peer specialists (N=37) to better understand delivery of peer support services for justice-involved individuals in Pennsylvania. Thematic analysis followed by directed content analysis was used to identify factors in three a priori implementation categories based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) model: initial facilitators (adoption), barriers (implementation), and facilitators (maintenance) to long-term sustainability. RESULTS Initial service adoption was facilitated by buy-in from recovery-oriented gatekeepers in the criminal justice system. Unique implementation barriers included the chasm between the orientations of the two systems (recovery vs. punitive) and formal and informal limitations on the employment of individuals with criminal justice system exposure. For services to be sustainable and have an impact over the long term, FPS advocates and workers must develop rapport with on-the-ground employees of the criminal justice system. Funding barriers specific to the criminal justice system limited the adoption, implementation, and maintenance of FPS services. CONCLUSIONS Although many of the factors that affect FPS service implementation were similar to those identified in the broader peer support literature, important differences must be addressed for successful FPS service delivery. Within the criminal justice system, both policies and norms presented barriers to the expansion of peer support services for justice-involved individuals.
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Affiliation(s)
- Wallis E Adams
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston (Adams, Lincoln); Department of Sociology, California State University, East Bay, Hayward (Adams)
| | - Alisa K Lincoln
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston (Adams, Lincoln); Department of Sociology, California State University, East Bay, Hayward (Adams)
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