Important implementation constructs for federal agencies in health and human service settings that are selecting, monitoring, and supporting grantees

Background:Federal agencies and other funders seeking to maximise their impact aim to understand factors associated with implementing evidence-based interventions (EBIs) to address health problems. Challenges exist, however, in synthesising information from different disciplines and reaching agreement about these factors due to different terminology, frameworks, and measures being used in different fields. Methods:A mixed-methods approach was used to identifying a set of implementation constructs helpful for selecting, monitoring, and supporting federal grantees in health and human service settings. Three phases of research were conducted: a literature review, structured expert interviews, and consensus building. Interviews with implementation experts were used to validate a set of implementation constructs identified in the literature review as strongly and consistently related to successful implementation of EBIs in international contexts. A modified Delphi approach was used with a technical working group (TWG) of federal staff to agree on the constructs most relevant for federally funded EBIs. Findings:This process yielded 11 constructs related to either the intervention, the intersection between the invention and context, or the implementation process. These constructs are areas of interest when integrating research evidence into routine practice. Expert interviewees recommended establishing clear, consistent construct definitions before developing valid, feasible measures of the constructs. In contrast to the numerous and specific constructs advanced by researchers, federal TWG members favoured fewer constructs with more generalisability. Discussion and conclusions:This article demonstrates the translation work required for policy contexts and highlights a successful approach to translate evidence from implementation science research for federal staff.

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Management of Pyrexia Associated with the Combination of Dabrafenib and Trametinib: Canadian Consensus Statements

Current Oncology ◽

10.3390/curroncol28050304 ◽

2021 ◽

Vol 28 (5) ◽

pp. 3537-3553

Author(s):

Alia Thawer ◽

Wilson H. Miller ◽

Nancy Gregorio ◽

Joël Claveau ◽

Sudha Rajagopal ◽

...

Keyword(s):

Working Group ◽

Treatment Algorithm ◽

Practice Variation ◽

Routine Practice ◽

Group Consensus ◽

Therapeutic Approaches ◽

Modified Delphi ◽

Delphi Approach ◽

Consensus Statements

The combination of dabrafenib and trametinib is a well-established treatment for BRAF-mutated melanoma. However, the effectiveness of this approach may be hindered by the development of treatment-related pyrexia syndrome, which occurs in at least 50% of treated patients. Without appropriate intervention, pyrexia syndrome has the potential to worsen and can result in hypotension secondary to dehydration and associated organ-related complications. Furthermore, premature treatment discontinuation may result in a reduction in progression-free and overall survival. Despite existing guidance, there is still a wide variety of therapeutic approaches suggested in the literature for both the definition and management of dabrafenib and trametinib-related pyrexia. This is reflected in the practice variation of its prevention and treatment within and between Canadian cancer centres. A Canadian working group was formed and consensus statements were constructed based on evidence and finalised through a two-round modified Delphi approach. The statements led to the development of a pyrexia treatment algorithm that can easily be applied in routine practice. The Canadian working group consensus statements serve to provide practical guidance for the management of dabrafenib and trametinib-related pyrexia, hopefully leading to reduced discontinuation rates, and ultimately improve patients’ quality of life and cancer-related outcomes.

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Strategies for Successful Implementation of Innovation

International Journal of Innovation in the Digital Economy ◽

10.4018/ijide.2017040102 ◽

2017 ◽

Vol 8 (2) ◽

pp. 16-28 ◽

Cited By ~ 6

Author(s):

Neeta Baporikar

Keyword(s):

Grounded Theory ◽

Literature Review ◽

Implementation Process ◽

Successful Implementation ◽

Innovation Implementation ◽

Implementation Processes ◽

Innovation Processes ◽

Multiple Causes

Innovations are vital to most organizations especially in this competitive and globalized scenario. Nevertheless, the results of innovations are in many cases far from satisfactory. Several studies have shown that an organization's failure to benefit from an adopted innovation can often be attributed to a deficient implementation process rather than to the innovation itself. Thus, the implementation process is a critical interface between the decision to adopt and the routine usage of an innovation. Ways and methods to implement innovation effectively have been under scholarship for some time now. Despite the number of studies which identify multiple causes of unsuccessful implementation processes, literature is lacking regarding the crucial aspects of innovation implementation. Building on the derived knowledge of the underlying dynamics of innovation processes, through grounded theory and in-depth literature review, the present study aims to contribute to existing implementation literature by examining the strategic facets of innovation implementation.

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Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

10.21203/rs.2.23235/v4 ◽

2020 ◽

Author(s):

Nicole Etherington ◽

Isabel Braganca Rodrigues ◽

Lora Giangregorio ◽

Ian D. Graham ◽

Alison M Hoens ◽

...

Keyword(s):

Theoretical Domains Framework ◽

Implementation Process ◽

Barriers And Facilitators ◽

Implementation Barriers ◽

Modified Delphi ◽

Delphi Approach ◽

Effective Interventions ◽

Novel Approach ◽

Interdisciplinary Framework ◽

Context Shapes

Abstract Background: A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors (e.g. age, gender) and structures of power (e.g. ageism, sexism), offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods: An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the TDF and its domains. An iterative approach aimed at building consensus was used to finalize recommendations.Results: Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality alongside the TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Considerations and prompts were designed to assist users to reflect on how individual identities and structures of power may play a role in barriers and facilitators to behaviour change and subsequent intervention implementation. Conclusions: Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. Considering the role of intersecting social factors when identifying barriers and facilitators to implementing research evidence may result in more targeted and effective interventions that better reflect the realities of those involved.

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Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

10.21203/rs.2.23235/v3 ◽

2020 ◽

Author(s):

Nicole Etherington ◽

Isabel Braganca Rodrigues ◽

Lora Giangregorio ◽

Ian D. Graham ◽

Alison M Hoens ◽

...

Keyword(s):

Theoretical Domains Framework ◽

Implementation Process ◽

Barriers And Facilitators ◽

Implementation Barriers ◽

Modified Delphi ◽

Delphi Approach ◽

Effective Interventions ◽

Novel Approach ◽

Interdisciplinary Framework ◽

Context Shapes

Abstract Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors (e.g. age, gender) and structures of power (e.g. ageism, sexism), offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the and its domains TDF. An iterative approach aimed at building consensus was used to finalize recommendations. Results Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality-enhanced TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Considerations and prompts were designed to assist users to reflect on how individual identities and structures of power may play a role in barriers and facilitators to behaviour change and subsequent intervention implementation. Conclusions Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. Considering the role of intersecting social factors when identifying barriers and facilitators to implementing research evidence may result in more targeted and effective interventions that better reflect the realities of those involved.

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Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

10.21203/rs.2.23235/v1 ◽

2020 ◽

Author(s):

Nicole Etherington ◽

Isabel Braganca Rodrigues ◽

Lora Giangregorio ◽

Ian D. Graham ◽

Alison M Hoens ◽

...

Keyword(s):

Majority Vote ◽

Theoretical Domains Framework ◽

Implementation Process ◽

Social Identities ◽

Implementation Barriers ◽

Modified Delphi ◽

Delphi Approach ◽

Novel Approach ◽

Interdisciplinary Framework ◽

Context Shapes

Abstract Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors and structures of power, offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. The modified Delphi involved two rounds of online voting followed by a final majority vote. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the and its domains TDF. An iterative approach aimed at building consensus was used to finalize recommendations. Results Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality-enhanced TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Conclusions Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. By considering the role of intersecting social factors when selecting, tailoring, and implementing KT interventions, they may become more effective.

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Implementing social prescribing in primary care in areas of high socioeconomic deprivation: process evaluation of the ‘Deep End’ community links worker programme

British Journal of General Practice ◽

10.3399/bjgp.2020.1153 ◽

2021 ◽

pp. BJGP.2020.1153

Author(s):

Nai Rui Chng ◽

Katie Hawkins ◽

Bridie Fitzpatrick ◽

Catherine O'Donnell ◽

Mhairi MacKenzie ◽

...

Keyword(s):

Primary Care ◽

Process Evaluation ◽

Health Inequalities ◽

Implementation Process ◽

Normalisation Process Theory ◽

Routine Practice ◽

Successful Implementation ◽

Fully Integrated ◽

Social Prescribing ◽

Deprived Areas

Background: Social prescribing involving primary care-based ‘link workers’ is a key UK health policy which aims to reduce health inequalities. However, the process of implementation of the link worker approach has received little attention despite this being central to desired impact and outcomes. Aim: Our objective was to explore the implementation process of such an approach in practice. Design and Setting: Qualitative process evaluation of the ‘Deep End’ Links Worker Programme (LWP) over a two-year period, in seven general practices in deprived areas of Glasgow. Methods: We used thematic analysis to identify the extent of LWP integration in each practice and key factors associated with implementation. Analysis was informed by Normalisation Process Theory. Results: Only three of the seven practices fully integrated the LWP into routine practice within two years, based on NPT constructs of coherence, cognitive participation, and collective action. Compared to ‘Partially Integrated Practices’, ‘Fully Integrated Practices’ had better shared understanding of the programme among staff, higher staff engagement with LWP, and were implementing all aspects of LWP at patient, practice and community levels of intervention. Successful implementation was associated with GP buy-in, collaborative leadership, good team dynamics, link worker support, and the absence of competing innovations. Conclusions: Even in a well-resourced government funded programme, the majority of practices involved had not fully integrated the LWP within the first two years. Implementing social prescribing and link workers within primary care at scale is unlikely to be a ‘quick fix’ for mitigating health inequalities in deprived areas.

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Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

10.21203/rs.2.21766/v1 ◽

2020 ◽

Author(s):

Nicole Etherington ◽

Isabel Braganca Rodrigues ◽

Lora Giangregorio ◽

Ian D. Graham ◽

Alison M Hoens ◽

...

Keyword(s):

Majority Vote ◽

Theoretical Domains Framework ◽

Implementation Process ◽

Social Identities ◽

Implementation Barriers ◽

Modified Delphi ◽

Delphi Approach ◽

Novel Approach ◽

Interdisciplinary Framework ◽

Context Shapes

Abstract Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors and structures of power, offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. The modified Delphi involved two rounds of online voting followed by a final majority vote. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the and its domains TDF. An iterative approach aimed at building consensus was used to finalize recommendations. Results Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality-enhanced TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Conclusions Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. By considering the role of intersecting social factors when selecting, tailoring, and implementing KT interventions, they may become more effective.

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Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

10.21203/rs.2.23235/v2 ◽

2020 ◽

Author(s):

Nicole Etherington ◽

Isabel Braganca Rodrigues ◽

Lora Giangregorio ◽

Ian D. Graham ◽

Alison M Hoens ◽

...

Keyword(s):

Theoretical Domains Framework ◽

Implementation Process ◽

Barriers And Facilitators ◽

Implementation Barriers ◽

Modified Delphi ◽

Delphi Approach ◽

Effective Interventions ◽

Novel Approach ◽

Interdisciplinary Framework ◽

Context Shapes

Abstract Background: A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors (e.g. age, gender) and structures of power (e.g. ageism, sexism), offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods: An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the and its domains TDF. An iterative approach aimed at building consensus was used to finalize recommendations.Results: Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality-enhanced TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Considerations and prompts were designed to assist users to reflect on how individual identities and structures of power may play a role in barriers and facilitators to behaviour change and subsequent intervention implementation. Conclusions: Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. Considering the role of intersecting social factors when identifying barriers and facilitators to implementing research evidence may result in more targeted and effective interventions that better reflect the realities of those involved.

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Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

10.2196/preprints.21629 ◽

2020 ◽

Author(s):

Hannah Liane Christie ◽

Lizzy Mitzy Maria Boots ◽

Huibert Johannes Tange ◽

Frans Rochus Josef Verhey ◽

Marjolein Elizabeth de Vugt

Keyword(s):

Self Efficacy ◽

Measurement Instrument ◽

Implementation Process ◽

Successful Implementation ◽

Evidence Based ◽

Multiple Sources ◽

Target Groups ◽

Face To Face ◽

People With Dementia ◽

Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

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