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Reisinger HS, Barron S, Balkenende E, Steffen M, Steffensmeier K, Richards C, Ball D, Chasco EE, Van Tiem J, Johnson NL, Jones D, Friberg JE, Kenney R, Moeckli J, Arora K, Rabin B. Tracking implementation strategies in real-world settings: VA Office of Rural Health enterprise-wide initiative portfolio. Health Serv Res 2024. [PMID: 39225446 DOI: 10.1111/1475-6773.14377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE To use a practical approach to examining the use of Expert Recommendations for Implementing Change (ERIC) strategies by Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) dimensions for rural health innovations using annual reports on a diverse array of initiatives. DATA SOURCES AND STUDY SETTING The Veterans Affairs (VA) Office of Rural Health (ORH) funds initiatives designed to support the implementation and spread of innovations and evidence-based programs and practices to improve the health of rural Veterans. This study draws on the annual evaluation reports submitted for fiscal years 2020-2022 from 30 of these enterprise-wide initiatives (EWIs). STUDY DESIGN Content analysis was guided by the RE-AIM framework conducted by the Center for the Evaluation of Enterprise-Wide Initiatives (CEEWI), a Quality Enhancement Research Initiative (QUERI)-ORH partnered evaluation initiative. DATA COLLECTION AND EXTRACTION METHODS CEEWI analysts conducted a content analysis of EWI annual evaluation reports submitted to ORH. Analysis included cataloguing reported implementation strategies by Reach, Adoption, Implementation, and Maintenance (RE-AIM) dimensions (i.e., identifying strategies that were used to support each dimension) and labeling strategies using ERIC taxonomy. Descriptive statistics were conducted to summarize data. PRINCIPAL FINDINGS A total of 875 implementation strategies were catalogued in 73 reports. Across these strategies, 66 unique ERIC strategies were reported. EWIs applied an average of 12 implementation strategies (range 3-22). The top three ERIC clusters across all 3 years were Develop stakeholder relationships (21%), Use evaluative/iterative strategies (20%), and Train/educate stakeholders (19%). Most strategies were reported within the Implementation dimension. Strategy use among EWIs meeting the rurality benchmark were also compared. CONCLUSIONS Combining the dimensions from the RE-AIM framework and the ERIC strategies allows for understanding the use of implementation strategies across each RE-AIM dimension. This analysis will support ORH efforts to spread and sustain rural health innovations and evidence-based programs and practices through targeted implementation strategies.
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Affiliation(s)
- Heather Schacht Reisinger
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Division of General Internal Medicine, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA
| | - Sheila Barron
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Erin Balkenende
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Division of General Internal Medicine, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Melissa Steffen
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Kenda Steffensmeier
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Chris Richards
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Dan Ball
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Emily E Chasco
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA
| | - Jennifer Van Tiem
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Nicole L Johnson
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - DeShauna Jones
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA
| | - Julia E Friberg
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Rachael Kenney
- Seattle-Denver Center of Innovation (COIN), Eastern Colorado VA Healthcare System, Aurora, Colorado, USA
| | - Jane Moeckli
- Center for Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Kanika Arora
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Borsika Rabin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- UC San Diego ACTRI Dissemination and Implementation Science Center, University of California San Diego, La Jolla, California, USA
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Amano T, Hooley C, Strong J, Inoue M. Strategies for implementing music-based interventions for people with dementia in long-term care facilities: A systematic review. Int J Geriatr Psychiatry 2022; 37. [PMID: 34647348 DOI: 10.1002/gps.5641] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/11/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Research has found that music-based interventions can decrease behavioral and psychological symptoms of dementia or behaviors that challenge (BPSD/BtC). However, how to effectively implement these interventions is unclear. This study synthesizes available evidence regarding implementation strategies and outcomes of music-based interventions for people with dementia at residential long-term care facilities. METHODS Study registered with PROSPERO (registration number: CRD42020194354). We searched the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library. Inclusion criteria included articles targeting music-based interventions conducted for people with dementia, studies conducted in residential long-term care facilities, and articles that reported implementation strategies and outcomes of the intervention. RESULTS Of the included eight studies, half were studies of music therapy and the other half were on individualized music. 49 implementation strategies were reported. The most frequently reported category of strategies was planning (34.7%), followed by education (24.5%), quality management (24.5%), restructuring (12.2%), and finance (4.1%). No strategies under the category of attending to the policy context were reported. The most frequently reported implementation outcomes were appropriateness (27.3%), followed by adoption (22.7%), fidelity (22.7%), acceptability (9.1%), sustainability (9.1%), and cost (9.1%). No studies measured feasibility or penetration. CONCLUSIONS Although various effective implementation strategies were identified, we were unable to examine the effectiveness of individual implementation strategies due to the designs of the selected studies. Less attention has been paid to strategies that aim at structural changes of intervention delivery systems. Future studies should investigate facilitators and barriers of implementing music-based interventions especially focusing on structural aspects.
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Affiliation(s)
- Takashi Amano
- Rutgers University - Newark, Newark, New Jersey, USA
| | | | - Joe Strong
- University of North Carolina - Greensboro, Greensboro, North Carolina, USA
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