Dissemination and Implementation of Evidence‐Based Dementia Care Using Embedded Pragmatic Trials

There is substantial variability in the implementation of evidence-based interventions across the United States, which leads to inconsistent access to evidence-based prevention and treatment strategies at a population level. Increased dissemination and implementation of evidence-based interventions could result in significant public health gains. While the availability of evidence-based interventions is increasing, study of implementation, adaptation, and dissemination has only recently gained attention in public health. To date, insufficient attention has been given to the issue of fidelity. Consideration of fidelity is necessary to balance the need for internal and external validity across the research continuum. There is also a need for a more robust literature to increase knowledge about factors that influence fidelity, strategies for maximizing fidelity, methods for measuring and analyzing fidelity, and examining sources of variability in implementation fidelity.

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The Role of Organizational Processes in Dissemination and Implementation Research

10.1093/oso/9780190683214.003.0008 ◽

2017 ◽

Cited By ~ 2

Author(s):

Gregory A. Aarons ◽

Joanna C. Moullin ◽

Mark G. Ehrhart

Keyword(s):

Health Care ◽

Organizational Development ◽

Organizational Factors ◽

Dissemination And Implementation ◽

Evidence Based ◽

Organizational Strategies ◽

Evidence Based Practices ◽

Effective Dissemination ◽

Dissemination And Implementation Research ◽

Ebp Implementation

Both organizational characteristics and specific organizational strategies are important for the effective dissemination and implementation of evidence-based practices (EBPs) in health and allied health care settings, as well as mental health, alcohol/drug treatment, and social service settings. One of the primary goals of this chapter is to support implementers and leaders within organizations in attending to and shaping the context in which implementation takes place in order to increase the likelihood of implementation success and long-term sustainment. The chapter summarizes some of the most critical organizational factors and strategies likely to impact successful evidence-based practice implementation. There are myriad approaches to supporting organizational development and change—this chapter focuses on issues supported by relevant scientific literatures, particularly those germane to EBP implementation in health care and related settings.

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Dissemination and Implementation Research in Health

10.1093/oso/9780190683214.001.0001 ◽

2017 ◽

Cited By ~ 48

Keyword(s):

Evidence Base ◽

Dissemination And Implementation ◽

Evidence Based ◽

Collaborative Partnerships ◽

Social Service Agencies ◽

Effective Interventions ◽

Health Related Research ◽

Health Related ◽

Dissemination And Implementation Research ◽

Policies And Programs

Fifteen to twenty years is how long it takes for the billions of dollars of health-related research to translate into evidence-based policies and programs suitable for public use. Over the past 15 years, an exciting science has emerged that seeks to narrow the gap between the discovery of new knowledge and its application in public health, mental health, and health care settings. Dissemination and implementation (D&I) research seeks to understand how to best apply scientific advances in the real world, by focusing on pushing the evidence-based knowledge base out into routine use. To help propel this crucial field forward, leading D&I scholars and researchers have collaborated to put together this volume to address a number of key issues, including: how to evaluate the evidence base on effective interventions; which strategies will produce the greatest impact; how to design an appropriate study; and how to track a set of essential outcomes. D&I studies must also take into account the barriers to uptake of evidence-based interventions in the communities where people live their lives and the social service agencies, hospitals, and clinics where they receive care. The challenges of moving research to practice and policy are universal, and future progress calls for collaborative partnerships and cross-country research. The fundamental tenet of D&I research—taking what we know about improving health and putting it into practice—must be the highest priority. This book is nothing less than a roadmap that will have broad appeal to researchers and practitioners across many disciplines.

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Adapting the SHARE Program for Use With Families Facing the Challenges of Chronic Illness

Innovation in Aging ◽

10.1093/geroni/igaa057.2134 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 626-626

Author(s):

Silvia Orsulic-Jeras ◽

Carol Whitlatch

Keyword(s):

Chronic Illness ◽

Disease Progression ◽

Chronic Conditions ◽

Family Care ◽

Diagnostic Procedures ◽

Dementia Care ◽

Evidence Based ◽

Positive Outcomes ◽

Community Settings ◽

Care Partners

Abstract Advances in diagnostic procedures have helped to make diagnosing Alzheimer’s disease and other dementias more accurate and to occur earlier in the disease progression. For persons living with dementia and their family care partners, finding programs that meet their needs for support post diagnosis can be challenging. Likewise, for persons with chronic conditions, few programs exist which help care dyads to create a manageable plan of care that addresses each person’s concerns and fears. SHARE, (Support, Health, Activities, Resources, and Education), originally designed for dementia care partners, has shown positive outcomes for both members of the care partnership. This presentation describes the development of the six-session SHARE intervention, its implementation in community settings, and its current standing as an evidence-based program and product that has been commercialized. Discussion will also focus on adapting SHARE for use with chronic illness families, highlighting revisions to program procedures, materials, recruitment, and evaluation.

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Dementia Care: An Evidence-Based Approach

Activities Adaptation & Aging ◽

10.1080/01924788.2018.1457858 ◽

2018 ◽

Vol 42 (2) ◽

pp. 165-165

Author(s):

Boyd H. Davis

Keyword(s):

Dementia Care ◽

Evidence Based

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A Collaborative Model for Facilitating the Delivery of Smoking Cessation Treatments to Cancer Patients: Results From Three Oncology Practices in South Carolina

The Journal of Smoking Cessation ◽

10.1017/jsc.2018.23 ◽

2018 ◽

Vol 14 (2) ◽

pp. 112-124

Author(s):

Daniel J. Kilpatrick ◽

Kathleen B. Cartmell ◽

Abdoulaye Diedhiou ◽

K. Michael Cummings ◽

Graham W. Warren ◽

...

Keyword(s):

Smoking Cessation ◽

South Carolina ◽

Quality Improvement ◽

Collaborative Learning ◽

Cancer Patients ◽

Tobacco Use ◽

Tobacco Cessation ◽

Dissemination And Implementation ◽

Evidence Based ◽

Cancer Centers

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.

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OP27 Dissemination and implementation in dementia care practice: a systematic scoping review

Journal of Epidemiology & Community Health ◽

10.1136/jech-2016-208064.27 ◽

2016 ◽

Vol 70 (Suppl 1) ◽

pp. A19.2-A19

Author(s):

I Lourida ◽

R Abbott ◽

I Lang ◽

M Rogers ◽

B Kent ◽

...

Keyword(s):

Scoping Review ◽

Dementia Care ◽

Care Practice ◽

Dissemination And Implementation

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Critical Appraisal on the Selection Criteria for Evidence-based Healthcare

10.21203/rs.3.rs-145261/v1 ◽

2021 ◽

Author(s):

Paulo Cesar Morales Mayer ◽

Caroline Amélia Gonçalves ◽

Franz Porzsolt

Keyword(s):

Cervical Cancer ◽

Clinical Trials ◽

Selection Criteria ◽

Human Subjects ◽

Evidence Based ◽

Inclusion Criteria ◽

Pragmatic Trials ◽

Exclusion Criteria ◽

Policy Makers ◽

Evidence Based Healthcare

Abstract Background: Evidence-Based healthcare deals basically with published clinical trials to guide the decision making on what treatment to use for any specific conditions.Aims: The present paper assessed the inclusion and exclusion criteria used in clinical trials of cervical cancer aiming at establishing a clear distinction between each criterion.Methods: We performed a bibliographical search in pubmed with the terms cervical cancer and treatment or therapy filtered for clinical trials with human subjects for the last ten years. A total of 30 papers were used extracting and classifying the inclusion and exclusion category according to the characteristic they described. Results: We found no clear parameter to establish which criteria could exclusively serve as inclusion or exclusion across the papers, about 56% of the categories identified were found either listed as inclusion or exclusion criteria or even as both in some cases.Conclusions: The key issue of selection criteria is not in its form but in its function, the first point to consider is if the trial is experimental (focused on efficacy and proof of principle) or observational (pragmatic trials, focused on effectiveness and real world conditions). We suggest, inclusion criteria should be broad, focused on the investigated condition; exclusion criteria should apply only to the subset of this “included” population, and do not take part in observational studies. These conclusions do not serve only for researchers but should affect practitioners and policy makers to correctly compare the results of investigated treatment.

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DEVELOPING AND IMPLEMENTING ALIVIADO DEMENTIA CARE IN HOSPICES: CHALLENGES ENCOUNTERED AND LESSONS LEARNED

Innovation in Aging ◽

10.1093/geroni/igz038.1325 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S363-S363

Author(s):

Abraham A Brody ◽

Shih-Yin Lin ◽

Catherine E Schneider ◽

Alycia A Bristol ◽

Kimberly E Convery ◽

...

Keyword(s):

Dementia Care ◽

Lessons Learned ◽

Workforce Training ◽

Evidence Based ◽

Morbid Condition ◽

Health Records ◽

Level Change ◽

Metastatic Solid Tumor ◽

Performing Culture

Abstract Hospice was originally developed to care for individuals with metastatic, solid-tumor cancers. While advanced ADRD is now the primary illness in approximately 19% of the hospice population and presents as a co-morbid condition in many more, little evidence-based work has been performed to retool hospice to care for persons with ADRD and their caregivers. Aliviado Dementia Care-Hospice Edition is a systems level change program consisting of hospice workforce training, an implementation toolbox, and agency-wide workflow changes. Aliviado seeks to improve the quality of life for persons with ADRD and their caregivers receiving hospice, focused specifically on BPSD and pain assessment and management. In developing a coalition of hospice agencies and implementing this pragmatic intervention, we discuss our solutions to overcoming a number of barriers, including varying electronic health records, performing culture change with a disseminated workforce, scaling to 25 hospices, and working with some hospices who lack experience performing research.

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Cognitive stimulation therapy in dementia care: exploring the views and experiences of service providers on the barriers and facilitators to implementation in practice using Normalization Process Theory

International Psychogeriatrics ◽

10.1017/s1041610217001272 ◽

2017 ◽

Vol 29 (11) ◽

pp. 1869-1878 ◽

Cited By ~ 12

Author(s):

Claire Dickinson ◽

Grant Gibson ◽

Zoe Gotts ◽

Lynne Stobbart ◽

Louise Robinson

Keyword(s):

Psychosocial Intervention ◽

Cost Effective ◽

Dementia Care ◽

Normalization Process Theory ◽

Cognitive Stimulation ◽

Process Theory ◽

Evidence Based ◽

Cognitive Stimulation Therapy ◽

People With Dementia ◽

Normalization Process

ABSTRACTBackground:Cognitive stimulation therapy (CST) is an evidence-based, cost-effective psychosocial intervention for people with dementia but is currently not a standard part of post-diagnostic care. This qualitative study explored the views and experiences of dementia care providers on the barriers and facilitators to its implementation in usual care.Method:Thirty four semi-structured interviews (24 participants) were conducted across four dementia care sites in the North of England; ten were follow-up interviews. Data were analyzed using thematic analysis and then mapped to the Normalization Process Theory framework.Results:Participants considered CST a “good fit” with their “preferred” ways of working and goals of dementia care namely the provision of person-centered services. For facilitators delivering the intervention, compared to other behavioral interventions, CST was seen to offer benefits to their work and was easy to understand as an intervention. Training in CST and seeing benefits for clients were important motivators. Time and resources were crucial for the successful implementation of CST. Participants were keen to objectively measure benefits to participants but unsure how to do this.Conclusions:CST is a cost-effective psychosocial intervention for people with dementia, recommended by national guidance. Despite our findings which show that, using the NPT framework, there are more facilitators than barriers to the implementation of CST, it is still not a standard part of post-diagnostic dementia care. Further research is needed to explore the reasons for this implementation gap in ensuring evidence-based care in translated into practice.

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