scholarly journals Iowa Implementation for Sustainability Framework

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Laura Cullen ◽  
Kirsten Hanrahan ◽  
Stephanie W. Edmonds ◽  
Heather Schacht Reisinger ◽  
Michele Wagner
Keyword(s):  
Diffusion Of Innovations ◽  
Implementation Strategies ◽  
Nurse Leaders ◽  
Implementation Framework ◽  
Hospital System ◽  
Highly Educated ◽  
The Usa ◽  
Cultural Domain ◽  
Ebp Implementation ◽  
Sustainability Framework

Abstract Background An application-oriented implementation framework designed for clinicians and based on the Diffusion of Innovations theory included 81 implementation strategies with suggested timing for use within four implementation phases. The purpose of this research was to evaluate and strengthen the framework for clinician use and propose its usefulness in implementation research. Methods A multi-step, iterative approach guided framework revisions. Individuals requesting the use of the framework over the previous 7 years were sent an electronic questionnaire. Evaluation captured framework usability, generalizability, accuracy, and implementation phases for each strategy. Next, nurse leaders who use the framework pile sorted strategies for cultural domain analysis. Last, a panel of five EBP/implementation experts used these data and built consensus to strengthen the framework. Results Participants (n = 127/1578; 8% response) were predominately nurses (94%), highly educated (94% Master’s or higher), and from across healthcare (52% hospital/system, 31% academia, and 7% community) in the USA (84%). Most (96%) reported at least some experience using the framework and 88% would use the framework again. A 4-point scale (1 = not/disagree to 4 = very/agree) was used. The framework was deemed useful (92%, rating 3–4), easy to use (72%), intuitive (67%), generalizable (100%), flexible and adaptive (100%), with accurate phases (96%), and accurate targets (100%). Participants (n = 51) identified implementation strategy timing within four phases (Cochran’s Q); 54 of 81 strategies (66.7%, p < 0.05) were significantly linked to a specific phase; of these, 30 (55.6%) matched the original framework. Next, nurse leaders (n = 23) completed a pile sorting activity. Anthropac software was used to analyze the data and visualize it as a domain map and hierarchical clusters with 10 domains. Lastly, experts used these data and implementation science to refine and specify each of the 75 strategies, identifying phase, domain, actors, and function. Strategy usability, timing, and groupings were used to refine the framework. Conclusion The Iowa Implementation for Sustainability Framework offers a typology to guide implementation for evidence-based healthcare. This study specifies 75 implementation strategies within four phases and 10 domains and begins to validate the framework. Standard use of strategy names is foundational to compare and understand when implementation strategies are effective, in what dose, for which topics, by whom, and in what context.

scholarly journals Barriers to implementing motivational interviewing in addiction treatment: A nominal group technique process evaluation

2021 ◽  
Vol 2 ◽  
pp. 263348952110184
Author(s):  
Melissa R Hatch ◽  
Kristine Carandang ◽  
Joanna C Moullin ◽  
Mark G Ehrhart ◽  
Gregory A Aarons
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Nominal Group Technique ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Nominal Group ◽  
Management Level ◽  
Implementation Program ◽  
Ebp Implementation ◽  
Staff Level

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics. Methods: This study was conducted during the first cohort of a cluster randomized controlled trial testing the effectiveness of the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI) in substance use disorder treatment agencies and clinics. We used a modified nominal group technique (NGT) in which clinic leaders identified barriers faced during the implementation process. Barriers were categorized, then ranked and rated according to leaders’ perceptions of each barrier’s influence on implementation. The barriers were then contextualized through individual qualitative interviews. Results: Fifteen barriers were identified, grouped into staff-level barriers, management-level barriers, and implementation program barriers. Time and resistance to MI were rated as the most influential staff-level barriers. Among management-level barriers, time was also rated highest, followed by turnover and external contractual constraints. The most influential implementation barrier was client apprehension of recording for fidelity assessment and feedback. Individual interviews supported these findings and provided suggested adaptations for future implementation efforts. Conclusion: EBP implementation is an ongoing process whereby implementation strategies must be proactively and strategically tailored to address emergent barriers. This research described a process evaluation that was used to identify 15 emergent and/or persistent barriers related to staff, management, and the implementation program. Using implementation strategies that can be tailored and/or adapted to such emergent barriers is critical to implementation effectiveness. Plain Language Summary Unforeseen barriers often arise during the course of implementation. Conducting evaluations during implementation allows for tailoring the implementation strategy. As part of a larger study using the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI), we collected data from the first cohort of LOCI clinic leaders to identify barriers to MI implementation that persisted despite advanced planning and to understand unanticipated barriers that arose during implementation. Leaders identified 15 barriers faced during the implementation process that fell into three categories: staff-level barriers, management-level barriers, and implementation program barriers. The leaders ranked time as the most influential barrier at both the staff and management levels. Staff apprehension, resistance to MI implementation, and staff turnover were also of significant concern to leaders. Future implementation efforts may benefit from conducting a similar process evaluation during the implementation phase.

scholarly journals Coaches’ implementation strategies in providing social support to Singaporean university athletes: A case study

2019 ◽  
Vol 14 (5) ◽  
pp. 681-693
Author(s):  
Koon Teck Koh ◽  
Marja Kokkonen ◽  
Heng Rang Bryan Law
Keyword(s):  
Social Support ◽  
Implementation Strategies ◽  
Well Being ◽  
Implementation Framework ◽  
Support Strategies ◽  
Individual Sports ◽  
Sport Coaches ◽  
University Athletes

Coaches are effective providers of social support to their athletes. Although sport-specific measures of social support have been developed to better understand athletes’ perceptions of available support, limited amount of research has addressed how sport coaches implement specific social support strategies. The purpose of this study was to examine university coaches’ implementation strategies in providing various forms of social support to their athletes. A total of eight sport coaches from team and individual sports (four from each sport) were purposefully selected for this study. Coaches were individually interviewed. The interview transcripts were analysed using a thematic analysis. The results revealed that coaches from different sports shared similar strategies across emotional, esteem, informational and tangible dimensions, but with some distinguishable differences in the way these strategies were implemented. In documenting the lived experiences of sport coaches, key strategies valued highly among these coaches were highlighted, providing important implications for coaches to know how to incorporate these strategies into their coaching practice to better support athletes’ well-being and improve the quality of coaching. The findings also provide an implementation framework of social support that emphasizes key strategies for coaches to focus on in their coaching approaches.

scholarly journals Implementation Research: An Efficient and Effective Tool to Accelerate Universal Health Coverage

2019 ◽  
Author(s):  
Agnes Binagwaho ◽  
Miriam F. Frisch ◽  
Kelechi Udoh ◽  
Laura Drown ◽  
Jovial Thomas Ntawukuriryayo ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Universal Health Coverage ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Health Coverage ◽  
Positive Health ◽  
Implementation Framework ◽  
Variable Success ◽  
Positive Health Outcomes ◽  
Universal Health

Success in the implementation of evidence-based interventions (EBIs) in different settings has had variable success. Implementation research offers the approach needed to understand the variability of health outcomes from implementation strategies in different settings and why interventions were successful in some countries and failed in others. When mastered and embedded into a policy and implementation framework, the application of implementation research by countries can provide policy-makers and implementers with the knowledge necessary to work towards universal health coverage (UHC) with the effectiveness, efficiency, sustainability, and fidelity needed to achieve sustainable positive health outcomes for all. To achieve this goal however, work is needed by the communities of research producers and consumers to create more clarity on implementation research methodologies and to build capacity to apply them as a critical tool for countries on their path to achieving UHC.

scholarly journals Late, But Not Too Late? Postponement of First Birth Among Highly Educated US Women

2020 ◽  
Author(s):  
Natalie Nitsche ◽  
Hannah Brückner
Keyword(s):  
Family Formation ◽  
Tertiary Education ◽  
College Education ◽  
Postgraduate Education ◽  
Early Career ◽  
Low Fertility ◽  
First Birth ◽  
Highly Educated ◽  
The Usa ◽  
The Postponement

AbstractWe examine the link between the postponement of parenthood and fertility outcomes among highly educated women in the USA born in 1920–1986, using data from the CPS June Supplement 1979–2016. We argue that the postponement–low fertility nexus noted in demographic and biomedical research is especially relevant for women who pursue postgraduate education because of the potential overlap of education completion, early career stages, and family formation. The results show that women with postgraduate education differ from women with college education in terms of the timing of the first birth, childlessness, and completed fertility. While the postponement trend, which began with the cohorts born in the 1940s, has continued among highly educated women in the USA, its associations with childlessness and completed parity have changed considerably over subsequent cohorts. We delineate five distinct postponement phases over the 80-year observation window, consistent with variation over time in the prevalence of strategies for combining tertiary education and employment with family formation.

scholarly journals Policy Analysis: BSN in 10

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
New York ◽  
Political Theory ◽  
New York State ◽  
Nurse Leaders ◽  
Robert Wood Johnson Foundation ◽  
Institute Of Medicine ◽  
Bachelor Of Science ◽  
Entry Level ◽  
Highly Educated ◽  
Associates Degree

An on-going cry for decades from nurse leaders is a standardization of entry level education for Registered Nurses (RNs). The Institute of Medicine (IOM) report in 2010 spurred the requirement for an increased pool of bachelor’s prepared RNs by the year 2020 [1]. In a partnership with the Robert Wood Johnson Foundation (RWJF), the call was made by the IOM to augment the percentage of RNs with a baccalaureate degree to 80% [1, 2]. To align with the IOM recommendation, many states are in the process of developing “BSN in 10” legislation, however, New York State (NYS) was the first state to put this into law as Senate Bill S6768 [3]. This type of legislation mandates RNs with a diploma or associates degree to complete a bachelor’s program within ten years of obtaining their initial license. This paper will address the need for highly educated nurses and policy developed called “BSN in 10”, background into the Bachelor of Science in Nursing (BSN), developed policy, the stakeholders, driving political theory, and funding.

Abstract MP24: Comparison of on-site versus Remote Support for a Mobile-Device Pilot Study: A Collaboration Between the Framingham Heart Study and Health eHeart Study (FHS-HeH)

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Nicole L Spartano ◽  
Fangui Sun ◽  
Kathryn L Lunetta ◽  
Ludovic Trinquart ◽  
Maureen Valentino ◽  
...  
Keyword(s):  
Pilot Study ◽  
Framingham Heart Study ◽  
Implementation Strategies ◽  
Clinic Visit ◽  
Highly Educated ◽  
Email Address ◽  
Heart Study ◽  
Pressure Cuff ◽  
Device Use ◽  
Study Designs

Background: New “e-Cohort” study designs provide resource-effective methods for collecting participant data. It is unclear if implementing an e-cohort without direct, in-person participant contact can achieve successful participation rates. The FHS-HeH randomized pilot study compared two distinct implementation strategies for co-enrolling participants from the Framingham Heart Study (FHS) into the Health eHeart Study, a digital cohort with infrastructure for collecting mHealth data. Methods: FHS participants who had an email address and smartphone were randomized to one of two approaches: remote vs. on-site support. In the remote arm, participants received an email containing an enrollment URL, and, upon enrollment, were sent four Bluetooth sensor devices. Participants in the on-site arm were invited to visit FHS and were provided in-person support for enrollment and connecting the devices. Results: Compared to participants that declined, individuals that accepted an invitation to participate in our pilot study (n=101 remote , n=101 on-site ) were more often women, highly educated, and younger (Figure 1). All on-site participants completed the consent, compared to 93% of the remote arm. Of participants who consented to participate, connection and initial use of devices was also higher in the on-site arm (100% connected the activity monitor, 94% the blood pressure cuff and scale, and 84% the electrocardiogram) compared to the remote arm (74%, 75%, 80%, and 42%). Roughly 75-78% of those that initially connected in both arms were still using the devices by the 3 rd month and 58-60% were still participating by the 6 th month. Conclusions: Our pilot study demonstrated that deployment of mobile devices among middle-aged and older adults in the context of an on-site clinic visit was associated with higher initial rates of device use as compared to offering only remote support. Once connected, drop-off rates were similar in both groups.

scholarly journals Dissemination and Implementation Strategies of Lower Extremity Preventive Training Programs in Youth: A Clinical Review

2017 ◽  
Vol 9 (6) ◽  
pp. 524-531 ◽  
Author(s):  
Lindsay J. DiStefano ◽  
Barnett S. Frank ◽  
Hayley J. Root ◽  
Darin A. Padua
Keyword(s):  
Lower Extremity ◽  
Clinical Review ◽  
Program Effectiveness ◽  
Training Programs ◽  
Implementation Strategies ◽  
Lower Extremity Injury ◽  
Dissemination And Implementation ◽  
Level Of Evidence ◽  
Implementation Framework ◽  
Youth Athletes

Context: Neuromuscular preventive training programs effectively reduce injury and improve performance in youth athletes. However, program effectiveness is directly linked to program compliance, fidelity, and dosage. Preventive training programs are not widely adopted by youth sport coaches. One way to promote widespread dissemination and compliance is to identify implementation strategies that influence program adoption and maintenance. It is unknown how previously published programs have followed the elements of an implementation framework. The objective of this review was to evaluate how elements of the 7 steps of implementation, developed by Padua et al, have been performed in the evidence of lower extremity preventive training programs. Evidence Acquisition: A systematic review of the literature from 1996 through September 2016 was conducted using electronic databases. Investigations that documented implementation of a sport team-based neuromuscular preventive training program in youth athletes and measured lower extremity injury rates were included. Study Design: Clinical review. Level of Evidence: Level 4. Results: A total of 12 studies met the inclusion criteria and were reviewed. Information regarding the completion of any of the 7 steps within the implementation framework developed by Padua et al was extracted. None of the 12 articles documented completion of all 7 steps. While each study addressed some of the 7 steps, no study addressed maintenance or an exit strategy for youth athletes. Program implementation appears limited in obtaining administrative support, utilizing an interdisciplinary implementation team, and monitoring or promoting fidelity of the intervention. Conclusion: Despite strong evidence supporting the effectiveness of preventive training programs in youth athletes, there is a gap between short-term improvements and long-term implementation strategies. Future interventions should include all 7 steps of the implementation framework to promote transparent dissemination of preventive training programs.

scholarly journals Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oluwaseyifunmi Andi Agbejule ◽  
Nicolas H. Hart ◽  
Stuart Ekberg ◽  
Koczwara Bogda ◽  
Rahul Ladwa ◽  
...  
Keyword(s):  
Scoping Review ◽  
Clinical Care ◽  
Implementation Strategies ◽  
Implementation Framework ◽  
Organisation Of Care ◽  
Cancer Related Fatigue ◽  
Management Interventions ◽  
Sustainable Implementation ◽  
Implementation Studies ◽  
Implementation Models

Abstract Background Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research. Methods PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively. Results Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams’ Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported. Conclusions Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.

scholarly journals Dame Edna and ‘the help’

2021 ◽  
Vol 9 (4) ◽  
pp. 152-172
Author(s):  
Adrian Hale
Keyword(s):  
Latin American ◽  
The United States ◽  
Small Sample ◽  
Speech Community ◽  
Online Questionnaire ◽  
Language Competence ◽  
Highly Educated ◽  
The Us ◽  
The Usa ◽  
Latin American Immigrants

‘Dame Edna Everage’, a persona originally created by the Australian comedian Barry Humphries in 1955, is a character designed to simultaneously shock and amuse. Dame Edna voices (and satirizes) the discourse of ‘average’, older, politically conservative Anglo-Australians who feel compelled to ‘tell it like it is’ – no matter how offensive their opinions might be. In the Anglosphere, Edna’s humour is well understood and sustained international success has followed Edna for more than 60 years in Britain, Canada, the US and Australia. However, Edna occasionally misfires. In 2003, for instance, Edna’s satire outraged Latinos across the USA, in fulfillment of Poe’s Law (Aikin, 2009). Simply put, Latinos assumed that Edna’s comments satirising negative mainstream attitudes towards them were expressive of Edna’s authentic racism. This paper investigates the Edna joke in the overall context of failed humour and then specifically for the offensiveness it generated amongst the Latino minority in the United States. It then tests whether this reaction was the result of a discursive frame specific to the US context, by conducting an exploratory study amongst a small sample of highly educated Australian bilingual Latin American immigrants and their adult children, to see whether they thought Edna’s joke was funny. These Australian individuals of Latin American heritage responded via an online questionnaire, and an analysis of their responses is presented here. The study’s main finding is that while these individuals generally demonstrated a high comedic literacy across both English and Spanish, including a prior awareness of Edna’s and Australian humour, they overall rejected the intention and humour of Edna’s joke. This paper asserts that, when it comes to humour, some transnational migrant speech community loyalties transcend other notions of identity and language competence.

scholarly journals An Exploration of Unethical Behavior Attitude of Tertiary Level Students of Bangladesh

2020 ◽  
pp. 39-47
Author(s):  
Sirajul Arefeen ◽  
Muhammad Khairi Bin Mohyuddin ◽  
Mohammad Aktaruzzaman Khan
Keyword(s):  
Moral Education ◽  
Unethical Behavior ◽  
Student Life ◽  
Academic Organizations ◽  
Highly Educated ◽  
Skilled Manpower ◽  
The Usa ◽  
Financial Scandals ◽  
Student Today ◽  
And Training

In this competitive world highly skilled manpower is considered to play key role in developing a nation. On the other hand, highly educated people are blamed for recent business and financial scandals. Moreover, studies established that pupils who deceive in their student life are found to be engaged in immoral workplace conduct. The Student today is the future leader of the country. Hence, the combination of quality with morality is emphasized in the universities of in many developed counties like the USA, China, and moral education is being imparted at all stages of academic organizations and training centers from kindergarten to national academia. Therefore, the goal of the research is to explore the origins of the unethical behavior of University students of Bangladesh and recommend the means to improve the situation.

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