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Kirk JW, Stefansdottir NT, Andersen O, Lindstroem MB, Powell B, Nilsen P, Tjørnhøj-Thomsen T, Broholm-Jørgensen M. How do oilcloth sessions work? A realist evaluation approach to exploring ripple effects in an implementation strategy. J Health Organ Manag 2024; 38:195-215. [PMID: 38825598 DOI: 10.1108/jhom-01-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
PURPOSE To explore the mechanisms of the implementation strategy, "oilcloth sessions" and understand and explain the ripple effects of oilcloth sessions as a strategy to implement a new emergency department. DESIGN/METHODOLOGY/APPROACH A qualitative design was used whereby data were collected using field notes from an ethnographic study of the oilcloth sessions and follow-up semi-structured interviews with staff, managers and key employees who participated in the oilcloth sessions. The data analysis was inspired by the realist evaluation approach of generative causality proposed by Pawson and Tilley. FINDINGS The primary ripple effect was that the oilcloth sessions were used for different purposes than the proposed program theory, including being used as: (1) a stage, (2) a battlefield, (3) a space for imagination and (4) a strategic management tool influencing the implementation outcomes. The results bring essential knowledge that may help to explain why and how a well-defined implementation strategy has unplanned outcomes. ORIGINALITY/VALUE Unintended outcomes of implementation strategies are an underexplored issue. This study may help implementation researchers rethink the activities required to reduce unintended negative outcomes or explore potential unplanned outcomes and, in this way, hinder or enhance outcomes, effectiveness and sustainability. Future studies within implementation research should incorporate attention to unintended outcomes to fully understand the impact of implementation strategies.
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Affiliation(s)
- Jeanette Wassar Kirk
- Clinical Research Department, Hvidovre Hospital, Hvidovre, Denmark
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Ove Andersen
- Clinical Research Department, Hvidovre Hospital, Hvidovre, Denmark
- Emergency Department, Hvidovre Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Byron Powell
- Center for Mental Health Services Research, Brown School, Washington University in St Louis, St Louis, Missouri, USA
- Center for Dissemination and Implementation, Institute for Public Health, Washington University in St Louis, St Louis, Missouri, USA
- John T. Milliken Department of Medicine, Division of Infectious Diseases, School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Per Nilsen
- Department of Medicine, Health and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tine Tjørnhøj-Thomsen
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marie Broholm-Jørgensen
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Maya Jariego I, Muñoz Alvis A, Villar Onrubia D. Using personal network analysis to understand the interaction between programmes' facilitators and teachers in psychoeducational interventions. EVALUATION AND PROGRAM PLANNING 2024; 103:102410. [PMID: 38367350 DOI: 10.1016/j.evalprogplan.2024.102410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/15/2023] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
In this study we use personal network analysis to examine the social relationships taking place throughout programme implementation. Previous literature on psychosocial intervention has used network analysis techniques to examine: (a) the interaction between participants, (b) the facilitators' link to the intervention target group, (c) the transfer of knowledge between experts and facilitators, and (d) the interaction of facilitators with each other. However, there has been little research on how facilitators connect with other figures in their organisational context, impacting both intervention fidelity and the fit of the programme to the local context. In this study we combine the analysis of personal networks with qualitative interviews with 102 teachers in 72 schools in Barranquilla (Colombia), with whom we describe the implementation of the psychoeducational programmes Pisotón and Metodologías Flexibles. The results show that programme implementation networks not only rely on facilitators but also on the contribution of the schools' director of studies, the coupling with the regular classroom teachers, and occasional collaborations from the rest of the school staff. After conducting a cluster analysis, we detected the existence of two types of personal networks, some based on the functioning of highly cohesive teams and others with a greater level of centralisation around the head of studies. Implementation networks not only enable the implementation of programme activities, but also the integration of the programme into educational organisations. In the discussion we reflect on how the analysis of facilitators' personal networks can be used to improve the process of programme implementation.
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Coumoundouros C, El Arab RA, Farrand P, Hamilton A, Sanderman R, von Essen L, Woodford J. Potential Implementers' Perspectives on the Development and Implementation of an e-Mental Health Intervention for Caregivers of Adults With Chronic Kidney Disease: Qualitative Interview Study. JMIR Hum Factors 2023; 10:e51461. [PMID: 37792676 PMCID: PMC10692875 DOI: 10.2196/51461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND e-Mental health interventions can improve access to mental health support for caregivers of people living with chronic kidney disease (CKD). However, implementation challenges often prevent effective interventions from being put into practice. To develop an e-mental health intervention for caregivers of people living with CKD that is optimized for future implementation, it is important to engage professionals that may endorse or deliver the intervention (ie, potential implementers) during intervention development. OBJECTIVE This study aims to explore the perspectives of potential implementers working in kidney care, in mental health care, or at nonprofit organizations regarding the design and implementation of an e-mental health intervention for caregivers of people living with CKD. METHODS Potential implementers (N=18) were recruited via National Health Service Trusts, email, and social media advertisements to participate in semistructured video interviews. Interview questions were informed by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using a deductive analysis approach using the CFIR, with inductive coding applied to relevant data not captured by the framework. RESULTS A total of 29 generic categories, related to 17 CFIR constructs, were identified. The perceived fit between the intervention and implementation context (ie, existing service delivery models and work routines) and existing social networks among potential implementers were perceived as important factors in enhancing implementation potential. However, a need for capacity building among potential implementers to create systems to support the identification and referral of caregivers to an e-mental health intervention was identified. Equity concerns were raised regarding the intervention, highlighting the importance of incorporating an equity lens during intervention design to enhance accessibility and adoption. CONCLUSIONS Potential implementers provided valuable insights into key design and implementation factors to help inform the development of an e-mental health intervention for caregivers of people living with CKD. Incorporating their feedback can help ensure the intervention is acceptable and inform the selection of future implementation strategies to enhance the implementation potential of the intervention. Potential implementers should continue to be engaged throughout intervention development.
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Affiliation(s)
- Chelsea Coumoundouros
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Clinical Education, Development and Research (CEDAR), Psychology, University of Exeter, Exeter, United Kingdom
| | - Rabie Adel El Arab
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Paul Farrand
- Clinical Education, Development and Research (CEDAR), Psychology, University of Exeter, Exeter, United Kingdom
| | - Alexander Hamilton
- Exeter Kidney Unit, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
- Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Bunger AC, Yousefi-Nooraie R, Warren K, Cao Q, Dadgostar P, Bustos TE. Developing a typology of network alteration strategies for implementation: a scoping review and iterative synthesis. Implement Sci 2023; 18:10. [PMID: 37024916 PMCID: PMC10080780 DOI: 10.1186/s13012-023-01266-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/25/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Social networks transmit knowledge, influence, and resources. These relationships among patients, professionals, and organizations can shape how innovations are disseminated, adopted, implemented, and sustained. Network alteration interventions-interventions that change or rewire social networks-have the potential to be used as implementation strategies. Yet, the types, mechanisms, and effectiveness of these interventions for implementation are unclear. This scoping review and iterative synthesis identified and described network alteration strategies that could be tested for implementation. METHODS We used forward and backward citation tracking of influential articles on network interventions, bibliometric searches, and hand searches of peer-reviewed social network journals. At least two team members screened article titles/abstracts to identify studies that met inclusion criteria: empirical studies of an intervention, the intervention was designed to alter some element of a social network, and changes in social network metrics were measured at two or more time points. During full-text reviews, information about the network interventions, actors, ties, and main findings was extracted. Reporting was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). To develop our typology, we synthesized these results using an iterative team-based and consensus-building process. RESULTS Fifty-three articles met the inclusion criteria. The interventions described were conducted in healthcare systems or behavioral health systems (34%), communities (26.4%), and schools (22.6%). The majority included records describing interventions designed to alter social support, information-sharing, or friendship networks (65%) among individual actors (84.9%), or to increase ties. Eight strategies emerged. Three strategies targeted the general context: (1) change the environment, (2) create groups, and (3) change the composition. Four strategies targeted individual actors: change (4) motivations, (5) skills for networking, (6) knowledge of one's social network, and (7) prominence/roles. One strategy (8) targeted specific ties within the network (targeting a particular pair-wise relationship or changing the nature of an existing tie). CONCLUSION The network alteration strategies in this typology provide further operational specificity for how implementation strategies target relationships. Advancing these strategies will require greater theoretical specification, the development of strategies that target professionals and organizations, and studies that examine the impact on implementation outcomes.
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Affiliation(s)
- Alicia C Bunger
- College of Social Work, The Ohio State University, Columbus, OH, USA.
| | - Reza Yousefi-Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Keith Warren
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Qiuchang Cao
- Pepper Institute On Aging and Public Policy & Claude Pepper Center, Florida State University, Tallahassee, FL, USA
| | - Porooshat Dadgostar
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Tatiana E Bustos
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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Proctor E, Ramsey AT, Saldana L, Maddox TM, Chambers DA, Brownson RC. FAST: A Framework to Assess Speed of Translation of Health Innovations to Practice and Policy. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:107-119. [PMID: 35669171 PMCID: PMC9161655 DOI: 10.1007/s43477-022-00045-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/14/2022] [Indexed: 04/14/2023]
Abstract
The 17-year time span between discovery and application of evidence in practice has become a unifying challenge for implementation science and translational science more broadly. Further, global pandemics and social crises demand timely implementation of rapidly accruing evidence to reduce morbidity and mortality. Yet speed remains an understudied metric in implementation science. Prevailing evaluations of implementation lack a temporal aspect, and current approaches have not yielded rapid implementation. In this paper, we address speed as an important conceptual and methodological gap in implementation science. We aim to untangle the complexities of studying implementation speed, offer a framework to assess speed of translation (FAST), and provide guidance to measure speed in evaluating implementation. To facilitate specification and reporting on metrics of speed, we encourage consideration of stakeholder perspectives (e.g., comparison of varying priorities), referents (e.g., speed in attaining outcomes, transitioning between implementation phases), and observation windows (e.g., time from intervention development to first patient treated) in its measurement. The FAST framework identifies factors that may influence speed of implementation and potential effects of implementation speed. We propose a research agenda to advance understanding of the pace of implementation, including identifying accelerators and inhibitors to speed.
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Affiliation(s)
- Enola Proctor
- Brown School, Washington University in St. Louis, St. Louis, MO 63130 USA
| | - Alex T. Ramsey
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - Lisa Saldana
- Oregon Social Learning Center, Eugene, OR 97401 USA
| | - Thomas M. Maddox
- Healthcare Innovation Lab, BJC HealthCare/Washington University School of Medicine, St. Louis, MO 63110 USA
- Division of Cardiology, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - David A. Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, MD 20892 USA
| | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130 USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110 USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110 USA
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Granberg A, Matérne M, Lundqvist LO, Duberg A. Navigating change - managers' experience of implementation processes in disability health care: a qualitative study. BMC Health Serv Res 2021; 21:571. [PMID: 34112151 PMCID: PMC8190840 DOI: 10.1186/s12913-021-06570-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022] Open
Abstract
Background Effective implementation processes play a central role in health care organizations and affect the care of patients. Managers are pivotal in facilitating the use of new practices, but their experience and how it affects the implementation outcome are still largely unknown. In the field of disability health care in particular, managers experiences have scarcely been investigated. Therefore, the aim of this study is to explore managers’ experiences of the implementation process when transferring new practices into disability health care settings. Methods Semi-structured individual telephone interviews were conducted with managers at disability health care organizations in four administrative regions in central Sweden. A total of 23 managers with formal managerial responsibility from both public and private health care were strategically selected to be interviewed. The interviews were analysed using reflexive thematic analysis with an inductive approach. Results The analysis resulted in two themes about factors influencing the implementation process: firstly, Contextual factors set the agenda for what can be achieved, which highlighted aspects that hinder or enable the implementation process, such as internal and external conditions, the workplace culture, the employees and managers’ attitudes and openness to change: secondly, Leadership in the winds of change, which described the challenges of balancing managerial tasks with leading the change, and the importance of a leadership that involves the participation of the employees. Conclusions This study explored how and to what extent managers address and manage the implementation process and the many associated challenges. The findings highlight the importance of leadership support and organizational structure in order to transfer new practices into the work setting, and to encourage an organizational culture for leading change that promotes positive outcomes. We suggest that identifying strategies by focusing on contextual factors and on aspects of leadership will facilitate implementation processes. Trial registration The SWAN (Structured Water Dance Intervention) study was retrospectively registered on April 9, 2019 and is available online at ClinicalTrials.gov (ID: NCT03908801). Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06570-6.
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Affiliation(s)
- Anette Granberg
- University Health Care Research Center, Faculty of Medicine and Health, Orebro University, Orebro, Sweden.
| | - Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Orebro University, Orebro, Sweden.,The Swedish Institute for Disability Research, Orebro University, Orebro, Sweden
| | - Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Orebro University, Orebro, Sweden.,The Swedish Institute for Disability Research, Orebro University, Orebro, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Orebro University, Orebro, Sweden
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Yakovchenko V, McCullough MB, Smith JL, Gabrielian S, Byrne T, Bruzios KE, Koosis E, Smelson DA. Implementing a complex psychosocial intervention for unstably housed Veterans: A realist-informed evaluation case study. IMPLEMENTATION RESEARCH AND PRACTICE 2021; 2:26334895211049483. [PMID: 37090015 PMCID: PMC9978638 DOI: 10.1177/26334895211049483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Only 7% of individuals with co-occurring mental health and substance use disorder (COD) receive services for both conditions. We implemented and evaluated maintaining independence and sobriety through systems integration, outreach and networking-Veteran's edition (MISSION-Vet), an evidence-based manualized psychosocial intervention for Veterans with CODs. This paper identifies the generative mechanisms that explain "how, for whom, and under what conditions" MISSION-Vet adoption, implementation, and fidelity work when applied in a complex adaptive system with facilitation support. Methods Within two VA healthcare systems (Sites A and B), a hybrid III trial tested facilitation to implement MISSION-Vet. We conducted a two-site case study based on 42 semi-structured consolidated framework for implementation research (CFIR) guided interviews with site leadership, implementers (social workers, peer specialists), and team members (facilitators, site leads). Interviews were coded and CFIR constructs used to generate "Context + Mechanism = Outcome" configurations to understand the conditions of MISSION-Vet adoption, implementation, and fidelity. Results Site A was low, and Site B was high in adoption, implementation, and fidelity. Adoption hesitancy/eagerness (outcome) resulted from the interaction of "external policy" (context) dampening/encouraging a "tension for change" (mechanism). Implementation intensity (outcome) was based on how "peer pressure" or practice culture (context) activated staff "self-efficacy" (mechanism) to engage with MISSION-Vet and appraise its "relative advantage" over current practices (mechanism). Fidelity relied on how "staffing structure and availability" (context) activated/muted "facilitation" (mechanism) to result in strategy and intervention adaptation (outcome). Conclusions We delineated how specific contexts activated certain mechanisms to drive the different stages of implementation of a multi-faceted COD treatment intervention. Trial registration ClinicalTrials.gov, NCT02942979. Plain language abstract Implementation is inherently dynamic and influenced by interdependent factors operating at the individual, organizational, and system levels. This is especially true for complex interventions addressing co-occurring mental health and substance use disorders because such interventions involve multiple treatment modalities delivered simultaneously, in busy practice settings, with challenging populations. This paper pairs consolidated framework for implementation research (CFIR) constructs with a realist evaluation approached to generate configurations important to the adoption, implementation, and adaptation stages of a highly complex intervention addressing the behavioural health and housing needs of a vulnerable population. Each configuration describes how contextual factors trigger mechanisms to generate implementation outcomes and answers "what works for whom, in what circumstances and in what respects, and how?" These findings further our understanding of possible mechanisms of change and push us to be more precise about identifying causal relationships among constructs that contribute to the success of implementing complex interventions. This work also moves us to think theoretically and methodologically in a more dynamic fashion, thereby leading to more responsive implementation practice.
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Affiliation(s)
- Vera Yakovchenko
- Center for Healthcare Organization and
Implementation Research, Bedford, MA, USA
- VA Bridging the Care Continuum-Quality Enhancement Research
Initiative, Bedford, MA, USA
| | - Megan B. McCullough
- Center for Healthcare Organization and
Implementation Research, Bedford, MA, USA
- VA Bridging the Care Continuum-Quality Enhancement Research
Initiative, Bedford, MA, USA
- Boston University School of Public
Health, Boston, MA, USA
| | - Jeffrey L. Smith
- Central Arkansas Veterans
Healthcare System, Little Rock, AR, USA
| | - Sonya Gabrielian
- Veterans Affairs Greater Los Angeles
Health Care System, Los Angeles, CA, USA
| | - Thomas Byrne
- Center for Healthcare Organization and
Implementation Research, Bedford, MA, USA
- VA Bridging the Care Continuum-Quality Enhancement Research
Initiative, Bedford, MA, USA
- Boston University School of School of Social Work, Boston, MA,
USA
| | - Kathryn E. Bruzios
- Center for Healthcare Organization and
Implementation Research, Bedford, MA, USA
- VA Bridging the Care Continuum-Quality Enhancement Research
Initiative, Bedford, MA, USA
- Department of Psychiatry, University of
Massachusetts Medical School, Worcester, MA, USA
| | - Ella Koosis
- Veterans Affairs Greater Los Angeles
Health Care System, Los Angeles, CA, USA
| | - David A. Smelson
- Center for Healthcare Organization and
Implementation Research, Bedford, MA, USA
- VA Bridging the Care Continuum-Quality Enhancement Research
Initiative, Bedford, MA, USA
- Department of Psychiatry, University of
Massachusetts Medical School, Worcester, MA, USA
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Bunger AC, Navarro EI, Lewis CC. How Do Peers Shape Mental Health Clinicians' Attitudes Toward New Treatments? ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 48:440-449. [PMID: 33201402 DOI: 10.1007/s10488-020-01096-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 10/23/2022]
Abstract
Through everyday interactions, mental health clinicians are exposed to their colleagues' views toward new treatments, which can influence clinicians' own attitudes and implementation especially in high-stress environments. This study examines how exposure to peers' attitudes in the workplace through three common workplace interactions (advice sharing, discussion, and friendship) shapes clinicians' (n = 163) own attitudes toward measurement-based care (MBC). Clinicians tended to have more positive attitudes toward MBC with greater exposure to peers with positive attitudes through advice-sharing and informal workplace discussions, but not through friendships. Results highlight the importance of strong workplace relationships for implementation.
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Affiliation(s)
- Alicia C Bunger
- Ohio State University, College of Social Work, 1947 College Road, Columbus, OH, 43210, USA
| | - Elena I Navarro
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA
| | - Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA.
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Ramos-Vidal I, Palacio J, Villamil I, Uribe A. Examining the effect of the individual characteristics of implementers and the interaction of multiple relationships on the structure of psychosocial intervention teams. Implement Sci 2020; 15:69. [PMID: 32859225 PMCID: PMC7456066 DOI: 10.1186/s13012-020-01032-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Teams' structure may undergo modifications due to the individual attributes of actors and collective-level variables. This research aims to understand the effect of extensive experience working in the program and the simultaneous interaction among different relationships in the network structure of a team of implementers. The Psychosocial Care Program for Victims of Conflict is implemented by psychologists, social workers, and community advocates. METHODS A cross-sectional study was carried out. Multivariate analysis, quadratic assignment procedures, and graphic visualization are used to (a) determine how seniority affects the professionals' level of centrality in the program and (b) clarify how the interaction among professionals favors new relationships. RESULTS Longer-lasting professionals in the program report stronger network bonding, predisposition to work, and information exchange. The nonparametric permutation test indicates an intense association between the information requests submitted and received and between the predisposition to work network and the network of received information requests. The results are discussed to optimize the teams implementing the intervention programs. CONCLUSIONS Network analysis is a powerfull tool to evaluate program implementation processes. Analyzing the interactions among multiples relationships that emerge between members of multidisciplinary teams allows knowing how certain relationships (e.g., information exchange) triggering other kind of relationships (e.g., users referral). The implementers who have been collaborating in the program for a long time are key informants who can facilitate the process of adaptation of newly incorporated professionals.
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Affiliation(s)
- Ignacio Ramos-Vidal
- Department of Social Psychology, University of Seville, Seville, Spain
- Research Group CAVIDA, Universidad Pontificia Bolivariana, Montería, Colombia
| | - Jorge Palacio
- Faculty of Psychology, Universidad del Norte, Barranquilla, Colombia
| | - Ilse Villamil
- Research Group CAVIDA, Universidad Pontificia Bolivariana, Montería, Colombia
| | - Alicia Uribe
- Research Group CAVIDA, Universidad Pontificia Bolivariana, Montería, Colombia
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Are Principals’ Social Networks Associated with Interventions’ Social Validity? SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Allchin B, O'Hanlon B, Weimand BM, Boyer F, Cripps G, Gill L, Paisley B, Pietsch S, Wynne B, Goodyear M. An explanatory model of factors enabling sustainability of let's talk in an adult mental health service: a participatory case study. Int J Ment Health Syst 2020; 14:48. [PMID: 32670399 PMCID: PMC7346490 DOI: 10.1186/s13033-020-00380-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background While effective interventions have been developed to support families where a parent has a mental illness in Adult Mental Health Services, embedding and sustaining them is challenging resulting in families not having access to support. This study developed an explanatory model of influencers that had enabled sustainability of the Let’s Talk intervention in one service. Methods A participatory case study was used to build an explanatory model of sustainability at the service using theoretical frameworks. Qualitative and quantitative data was collected about practitioner’s practice and the organisation’s implementation process and capacity to support practice. A local research group worked with the researcher using a transforming data approach through description, analysis and interpretation. Results Influencers were grouped into four major categories: (1) External social, political and financial context, (2) Resources, (3) Prior organisational capacity and (4) Sustainability Factors. The last category, Sustainability factors, was divided into three subcategories: (4.1)Practitioner (4.2) Organisation and (4.3) Parent-Client. These categories form part of an explanatory model for the key influencers of continued practitioner practice and organisational capacity to support practice. Conclusions and implications for practice In this case study, the pre-existing organisational context along with practitioner, organisation and parent-client factors operated together to influence sustainability. The results suggest that sustainability is more likely to be supported by both linking Let’s Talk to existing organisational identity, capacity, structures and relationships and by supporting mutual adaptations to improve the fit. Additionally, by understanding that setbacks are common and ongoing adjustments are needed, implementers are able to have realistic expectations of sustainability.
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Affiliation(s)
- Becca Allchin
- School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC Australia.,Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Brendan O'Hanlon
- The Bouverie Centre, La Trobe University, Melbourne, VIC Australia
| | - Bente M Weimand
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Fran Boyer
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Georgia Cripps
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Lisa Gill
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Brooke Paisley
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Sian Pietsch
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Brad Wynne
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Melinda Goodyear
- School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC Australia.,Emerging Minds, Hilton, SA Australia
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The influence of peer beliefs on nurses' use of new health information technology: A social network analysis. Soc Sci Med 2020; 255:113002. [PMID: 32353652 DOI: 10.1016/j.socscimed.2020.113002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/23/2022]
Abstract
Implementation of health information technology fails at an alarming rate because intended users often choose not to use it. Implementation theory and frameworks suggest that social networks may influence individuals' use, but empirical study remains limited. Furthermore, neither theory nor research has identified whose beliefs within the network matter most for implementation. We examine the relationship between an individual's system use and the beliefs of his or her peers. We assess the relationship for two peer groups: the entire group of peers and the subset that shares the individual's beliefs about the system. We used data collected from an academic hospital in the United States that had recently implemented a bar code medication administration system, a technology meant to increase medication safety. We administered a survey to nurses (N = 207) in six clinical units approximately 3-5 months (April-June 2013) after the "go-live" of the system to identify peer groups and beliefs about system usefulness. We calculated mean peer belief for the entire peer group and sharedness of belief using a homophily measure. From the hospital's electronic health record system, we obtained nurses' system use during the 3-month data collection period. We used multivariable linear regression to examine relationships. We found no effect of mean peer beliefs on individual system use. However, sharedness of belief about usefulness was positively associated with individual system use. Individuals' own positive belief was only associated with greater system use when shared with peers. Our findings indicate a significant role of social networks in implementation, and specifically that shared beliefs between an individual and his or her peer network may be critical to implementation success, more so than the beliefs across the entire peer group. Reinforcement by the social network appears to dictate whether individuals' own beliefs translate into system use.
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Dekker M, van Mansfeld R, Vandenbroucke-Grauls C, de Bruijne M, Jongerden I. Infection control link nurse programs in Dutch acute care hospitals; a mixed-methods study. Antimicrob Resist Infect Control 2020; 9:42. [PMID: 32106884 PMCID: PMC7047353 DOI: 10.1186/s13756-020-0704-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background Infection control link nurse programs show considerable variation. We report how Dutch link nurse programs are organized, how they progress, and how contextual factors may play a role in the execution of these programs. Methods This mixed-methods study combined a survey and semi-structured interviews with infection control practitioners, based on items of the Template for Intervention Description and Replication (TIDieR) checklist. Results The Netherlands has 74 hospitals; 72 infection control practitioners from 72 different hospitals participated in the survey. Four of these infection control practitioners participated in interviews. A link nurse program was present in 67% of the hospitals; responsibility for 76% of these programs lied solely with the infection prevention and control team. The core component of most programs (90%) was education. Programs that included education on infection prevention topics and training in implementation skills were perceived as more effective than programs without such education or programs where education included only infection prevention topics. The interviews illustrated that these programs were initiated by the infection prevention team with the intention to collaborate with other departments to improve practice. Content for these programs was created at the time of their implementation. Infection control practitioners varied in their ability to express program goals and to engage experts and key stakeholders. Conclusions Infection control link nurse programs vary in content and in set up. Programs with a clear educational content are viewed as more successful by the infection control practitioners that implement these programs.
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Affiliation(s)
- Mireille Dekker
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, room PK1X132, 1081, HV, Amsterdam, The Netherlands.
| | - Rosa van Mansfeld
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, room PK1X132, 1081, HV, Amsterdam, The Netherlands
| | - Christina Vandenbroucke-Grauls
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, room PK1X132, 1081, HV, Amsterdam, The Netherlands
| | - Martine de Bruijne
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irene Jongerden
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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