scholarly journals Implementation Strategies for Widespread Scaling of Effective Programs into Healthcare systems

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 50-50
Author(s):  
Jaime Hughes

Abstract Translation of effective evidence-based programs into practice is critical to promoting and preserving older adults’ function and independence. This presentation will provide an introduction to implementation strategies, defined as the “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical program or practice.” Some examples of implementation strategies include education and training, stakeholder engagement, patient and/or consumer involvement, adaptation, and technical assistance. Application of these implementation strategies will be illustrated using examples from local and national scale out of evidence-based health promotion programs for older adults within the VA Healthcare System. This presentation will close with guidance on how to select, track, and evaluate implementation strategies.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 599-600
Author(s):  
Tracy Mitzner ◽  
Elena Remillard ◽  
Kara Cohen ◽  
Jordan Chen

Abstract Tele-technologies may be able to increase access to evidence-based exercise interventions for adults aging with long-term mobility disabilities. This population experiences substantial barriers in attending such programs in person, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. It is critical to overcome such barriers to ensure this population has an opportunity to receive the benefits of evidence-based programs. In this study we are translating an in-person evidence-based tai chi intervention, Tai Chi for Arthritis, to an online platform using videoconferencing software for those aging with long-term mobility disabilities. We will describe our approach of including users from the target population and industry representatives (videoconferencing software developer, Tai Chi for Arthritis program developer as well as local master trainer) in the adaptation of the intervention and present the key findings from doing so.


2021 ◽  
Author(s):  
Nancy Gell ◽  
Elise Hoffman ◽  
Kushang Patel

BACKGROUND Tele-exercise has emerged as a way for older adults to participate in group exercise during the COVID-19 pandemic. Yet, little is known about the technology support needs of older adults for accessing tele-exercise. OBJECTIVE Examine the interests and needs of older adults for transition to tele-exercise, 2) Identify barriers and facilitators of tele-exercise uptake and continued participation, and 3) Describe technology support challenges and successes encountered among older adults beginning tele-exercise. METHODS We used an exploratory sequential mixed method study design. Participants were older adults with symptomatic knee osteoarthritis (n=44) who started participating in remotely delivered Enhance Fitness. Prior to the start of classes, a subsample of participants (n=10) completed semi-structured phone interviews about technology support needs and barriers and facilitators for technology adoption. All participants completed surveys including the PROMIS-57, the Senior Technology Acceptance Model scale, and a technology needs assessment. The study team recorded technology challenges encountered when participants engaged in tele-exercise classes and attendance rates. RESULTS Four themes emerged from the interviews: Participants desire features in a tele-exercise program that foster accountability; importance of direct access to helpful people who can troubleshoot and provide guidance with technology; opportunities to participate in high value activities motivates willingness to persevere through technology concerns; and belief in the ability to learn new things supersedes technology-related anxiety. Among participants in the tele-exercise classes (mean age 74.0 years ± 6.3; 86.4% female; mean of 2.5 ± 0.9 chronic conditions), 70.5% had a computer with a webcam, but 40.9% had little or no experience with videoconferencing. Initial technology orientation sessions lasted, on average, 19.3 (±10.3) minutes and 23.9% required a follow-up assistance call. During the first two weeks of tele-exercise, 47.6% required technical assistance which decreased to 11.9% for weeks 3-16. Median attendance was 100% for the first six sessions and 93% for the subsequent 42 sessions. CONCLUSIONS With appropriate support, older adults can successfully participate in tele-exercise. Recommendations include individualized technology orientation sessions, experiential learning, and availability of stand-by technical assistance, particularly during the first two weeks of classes. Continued development of best practices in this area may allow previously hard-to reach populations of older adults to participate in health-enhancing, evidence-based exercise programs. CLINICALTRIAL NCT04099394


2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 459-459
Author(s):  
M Smith ◽  
L Eagle ◽  
S Lachenmayr ◽  
J Simon

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 625-625
Author(s):  
Luming Li

Abstract This individual symposium abstract will focus on evidence-based approaches to suicide in older adults, with particular focus on the Zero Suicide Model. Zero Suicide Model is a framework that applies seven essential elements of suicide care (Lead, Train, Identify, Engage, Treat, Transition, Improve). The model provides a systematic approach for quality improvement for suicide prevention and offers implementation strategies for “real-world” clinical settings using the Assess, Intervene, and Monitor for Suicide Prevention (AIM-SP) program for suicide-safer care. The authors will describe implementation of Zero Suicide in general healthcare settings that care for older adults, including health systems and outpatient clinics. The authors will also describe the value of Zero Suicide other settings such as long-term care centers, where older adults are cared for. In addition, the authors will describe future directions for research in the Zero Suicide Model and additional opportunities in public policy for suicide prevention.


2021 ◽  
pp. 153944922110222
Author(s):  
Juleen Rodakowski ◽  
Tracy M. Mroz ◽  
Carrie Ciro ◽  
Catherine L. Lysack ◽  
Jennifer L. Womack ◽  
...  

Older adults may benefit from interventions to successfully age in place. Research has an opportunity to test interventions and implementation strategies to fulfill the needs of older adults through collective evidence building. The purpose of this article is to describe the proceedings of the American Occupational Therapy Foundation (AOTF) 2019 Planning Grant Collective and describe the areas of research that were identified as critical. The AOTF convened scientists with expertise in the area of aging in place to catalyze research on aging in place for older adults. Four priority areas in the aging in place literature were highlighted: (a) identification of factors that support aging in place, (b) classification of processes by which family members and care partners are included in aging in place efforts, (c) categorization of technology supporting older adults to age in place, and (d) development of science that clarifies implementation of evidence-based practice.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 545-545
Author(s):  
Robin McAtee ◽  
Leah Tobey

Abstract The Arkansas Geriatric Education Collaborative (AGEC)’s Geriatric Workforce Enhancement Program is partnering with a plethora of community based organizations (CBO) and with ARcare, an Arkansas federally qualified healthcare clinic network, to implement the 4Ms of age-friendly care in rural clinics. Baseline clinical data related to the Age-Friendly 4M Framework has been gathered and quality improvement projects initiated to improve the outcomes. Initiatives to improve depression and cognitive screenings are addressing Mentation; fall prevention screens and the offering of fall prevention programs have been added for Mobility; high risk medication screens and chronic pain educational programs are being implemented to address Medications; and finally, Medicare Annual Wellness Visits is the cornerstone to improve what Matters to older adults. A campaign that involves partnered CBOs to address health literacy and increase involvement in evidence-based programs is also helping to drive improvements in age-friendly care in rural Arkansas.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 873-873
Author(s):  
Pamela Toto ◽  
Caylee Yanes ◽  
Molly Ennis ◽  
Beth Fields

Abstract Community Aging in Place, Advancing Better Living for Elders (CAPABLE) is an interdisciplinary evidence-based intervention for reducing disability, reducing cost, and promoting aging in place for older adults who qualify for Medicaid services. However, implementation of CAPABLE through existing community services and with different older adult populations may require adaptations based on stakeholder input. The purpose of this qualitative study was to adapt CAPABLE for implementation through an Area Agency on Aging (AAA) targeting older adults with disability but who do not meet thresholds for Medicaid services. Data collection occurred with stakeholders from a single AAA. Two, 60-minute focus groups were conducted with frontline providers (n=7) and administrators (n=7). Thematic analysis of the data were completed using NVivo 12 Pro. Stakeholders described three themes to consider for implementing CAPABLE in their AAA: screening and referral process, eligibility, and team meetings. Frontline providers recognized the need to allow care managers “to decide who would be most appropriate for the program because they have a better understanding of the person, their family, and home environment.” Administrators supported expanding eligibility requirements, “Could we offer the program to someone even if they were recently hospitalized?” All stakeholders expressed that an initial interdisciplinary team meeting could be beneficial for goal setting, “If the team and consumer could be together for the first meeting that could save time and help generate ideas for goals.” These perspectives affirm the importance of early stakeholder engagement in adapting to adopt evidence-based programs into “real-world” settings.


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