Evaluating factors that influenced the successful implementation of an evidence-based neonatal care intervention in Chinese hospitals using the PARIHS framework

Abstract Background Evidence based interventions (EBIs) can improve patient care and outcomes. Understanding the process for successfully introducing and implementing EBIs can inform effective roll-out and scale up. The Promoting Action on Research Implementation in Health Services (PARIHS) framework can be used to evaluate and guide the introduction and implementation of EBIs. To gain an understanding of the utility of the PARIHS framework in China and investigate how important each of its constructs (evidence, context and facilitation) and sub-elements are perceived to be to successful implementation of EBIs in a Chinese setting, we used the framework to assess the implementation of an evidence-based neonatal intervention (kangaroo mother care, KMC) recently introduced in selected Chinese hospitals. Method We conducted clinical observations and semi-structured interviews with 10 physicians and 18 nurses in five tertiary hospitals implementing KMC. Interview questions were organized around issues including knowledge and beliefs, resources, culture, implementation readiness and climate. We used directed content analysis to analyze the interview transcript, amending the PARIHS framework to incorporate emerging sub-themes. We also rated the constructs and sub-elements on a continuum from “low (weak)”, “moderate” or “high (strong)” highlighting the ones considered most influential for hospital level implementation by study participants. Results Our finding suggest that clinical experience, culture, leadership, evaluation, and facilitation are highly influential sub-elements for EBI implementation in China. External evidence had a moderate impact, especially in the initial awareness raising stages of implementation and resources were also considered to be of moderate importance, although this may change as implementation progresses. Patient experience was not seen as a driver for implementation at hospital level. Conclusion The PHARIS framework can be a useful tool for planning and evaluating EBI implementation in China. However, it’s sub-elements should be assessed and adapted to the implementation setting.

Download Full-text

Evaluation of the Implementation Process of the Mobile Health Platform ‘WelTel’ in Six Sites in East Africa and Canada Using the Modified Consolidated Framework for Implementation Research (mCFIR)

10.21203/rs.3.rs-127906/v1 ◽

2020 ◽

Author(s):

Samia El Joueidi ◽

Kevin Bardosh ◽

Richard Musoke ◽

Binyam Tilahun ◽

Maryam Abo Moslim ◽

...

Keyword(s):

Implementation Research ◽

Digital Health ◽

Descriptive Analysis ◽

Scale Up ◽

Implementation Process ◽

Evidence Based ◽

Structured Interviews ◽

User Friendliness ◽

Domain 3 ◽

And Performance

Abstract Background: Health systems globally are investing in integrating secure messaging platforms for virtual care in clinical practice. Implementation science is essential for adoption, scale-up, spread and maintenance of complex evidence-based solutions in clinics with evolving priorities. In response, the mHealth Research Group modified the existing Consolidated Framework for Implementation Research (mCFIR) to evaluate implementation of virtual health tools in clinical settings. WelTel® is an evidence-based digital health platform widely deployed in various geographical and health contexts. Objectives: To identify the facilitators and barriers for implementing WelTel and to assess the application of the mCFIR tool in facilitating focus groups in different geographical and health settings. Methodology: Both qualitative and semi-quantitative approaches were employed. Six mCFIR sessions were held in three countries with 51 key stakeholders surveyed. The mCFIR tool consists of 5 Domains and 25 Constructs and was built and distributed through Qualtrics XM. “Performance ” and “Importance” scores were valued on a scale of 0 to 10 (Mean + SD). Descriptive analysis was conducted using R computing software. NVivo 12 Pro software was used to analyze mCFIR responses and to generate themes from the participants’ input. Semi-structured interviews were conducted with the focus group facilitators to understand their experience using the mCFIR tool. Results: We observed a parallel trend in the scores for Importance and Performance. Of the five Domains, Domain 4 (End-user Characteristics) and Domain 3 (Inner Settings) scored highest in Importance (8.9 + 0.5 and 8.6 + 0.6, respectively) and Performance (7.6 + 0.7 and 7.2 + 1.3, respectively) for all sites. Domain 2 (Outer Setting) scored the lowest in both Importance and Performance for all sites (7.6 + 0.4 and 5.6 + 1.8). Areas of strengths included timely diagnosis, immediate response, cost-effectiveness, user-friendliness, and simplicity. Areas for improvement included training, phone accessibility, health authority’s engagement, and literacy. Conclusion: The mCFIR tool allowed for a comprehensive understanding of the barriers and facilitators to the implementation, reach, and scale-up of digital health tools. Participants emphasized the importance of creating partnerships with external organizations and health authorities in order to achieve sustainability and scalability.Trial Registration: NCT02603536 – November 11, 2015NCT01549457 – March 9, 2012

Download Full-text

A Roadmap to Inform the Implementation of Evidence-Based Collaborative Care Interventions in Communities: Insights From the Michigan Mental Health Integration Partnership

Frontiers in Public Health ◽

10.3389/fpubh.2021.655999 ◽

2021 ◽

Vol 9 ◽

Author(s):

Amy Rusch ◽

Lindsay M. DeCamp ◽

Celeste M. Liebrecht ◽

Seo Youn Choi ◽

Gregory W. Dalack ◽

...

Keyword(s):

Mental Health ◽

Best Practices ◽

Collaborative Care ◽

Project Teams ◽

Successful Implementation ◽

Evidence Based ◽

Structured Interviews ◽

Community Based ◽

Mental Health Integration ◽

Implementation Steps

Background: Despite increasing calls for further spread of evidence-based collaborative care interventions (EBIs) in community-based settings, practitioner-driven efforts are often stymied by a lack of experience in addressing barriers to community-based implementation, especially for those not familiar with implementation science. The Michigan Mental Health Integration Partnership (MIP) is a statewide initiative that funds projects that support implementation and uptake of EBIs in community-based settings. MIP also provides an in situ implementation laboratory for understanding barriers to the uptake of EBIs across a variety of settings. We report findings from a statewide qualitative study of practitioners involved in MIP projects to garner their perspectives of best practices in the implementation of EBIs.Methods: Twenty-eight semi-structured interviews of practitioners and researchers from six MIP Projects were conducted with individuals implementing various MIP EBI projects across Michigan, including stakeholders from project teams, implementation sites, and the State of Michigan, to identify common barriers, challenges, and implementation strategies deployed by the project teams, with the purpose of informing a set of implementation steps and milestones.Results: Stakeholders identified a number of barriers to and strategies for success, including the need for tailoring program deployment and implementation to specific site needs, development of web-based tools for facilitating program implementation, and the importance of upper-level administration buy-in. Findings informed our resultant community-based Implementation Roadmap, which identifies critical steps across three implementation phases—pre-implementation, implementation, and sustainability—for implementation practitioners to use in their EBI implementation efforts.Conclusion: Implementation practitioners interested in community-based EBI implementation often lack access to operationalized implementation “steps” or “best practices” that can facilitate successful uptake and evaluation. Our community-informed MIP Implementation Roadmap, offering generalized steps for reaching successful implementation, uses experiences from a diverse set of MIP teams to guide practitioners through the practices necessary for scaling up EBIs in community-based settings over pre-implementation, implementation and sustainability phases.

Download Full-text

Factors that influence implementation at scale of a community-based health promotion intervention for older adults

BMC Public Health ◽

10.1186/s12889-019-7984-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Joanie Sims-Gould ◽

Heather A. McKay ◽

Christa L. Hoy ◽

Lindsay Nettlefold ◽

Samantha M. Gray ◽

...

Keyword(s):

Older Adults ◽

Health Promotion ◽

Older Adult ◽

Contextual Factors ◽

Scale Up ◽

Project Team ◽

Successful Implementation ◽

Evidence Based ◽

Health Promotion Intervention ◽

The Impact

Abstract Background Despite the many known benefits of physical activity (PA), relatively few older adults are active on a regular basis. Older adult PA interventions delivered in controlled settings showed promising results. However, to achieve population level health impact, programs must be effectively scaled-up, and few interventions have achieved this. To effectively scale-up it is essential to identify contextual factors that facilitate or impede implementation at scale. Our aim is to describe factors that influence implementation at scale of a health promotion intervention for older adults (Choose to Move). This implementation evaluation complements our previously published study that assessed the impact of Choose to Move on older adult health indicators. Methods To describe factors that influenced implementation our evaluation targeted five distinct levels across a socioecological continuum. Four members of our project team conducted semi-structured interviews by telephone with 1) leaders of delivery partner organizations (n = 13) 2) recreation managers (n = 6), recreation coordinators (n = 27), activity coaches (n = 36) and participants (n = 42) [August 2015 – April 2017]. Interviews were audio-recorded and professionally transcribed and data were analyzed using framework analysis. Results Partners agreed on the timeliness and need for scaled-up evidence-based health promotion programs for older adults. Choose to Move aligned with organizational priorities, visions and strategic directions and was deemed easy to deliver, flexible and adaptable. Partners also noted the critical role played by our project team as the support unit. However, partners noted availability of financial resources as a potential barrier to sustainability. Conclusions Even relatively simple evidence-based interventions can be challenging to scale-up and sustain. To ensure successful implementation it is essential to align with multilevel socioecological perspectives and assess the vast array of contextual factors that are at the core of better understanding successful implementation.

Download Full-text

Implementation determinants and mechanisms for the prevention and treatment of adolescent HIV in sub-Saharan Africa: concept mapping of the NIH Fogarty International Center Adolescent HIV Implementation Science Alliance (AHISA) initiative

Implementation Science Communications ◽

10.1186/s43058-021-00156-3 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Gregory A. Aarons ◽

Kendal Reeder ◽

Nadia A. Sam-Agudu ◽

Susan Vorkoper ◽

Rachel Sturke

Keyword(s):

Hiv Prevention ◽

Implementation Science ◽

Concept Mapping ◽

Scale Up ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Evidence Based ◽

Treatment Implementation ◽

Prevention And Treatment ◽

Sub Saharan

Abstract Introduction Adolescent HIV prevention and treatment is a high priority for youth healthcare in sub-Saharan Africa. Methods This study employed concept mapping to identify factors that impact the implementation of HIV prevention and intervention programs for adolescents in sub-Saharan Africa. Key stakeholders including researchers, policymakers, and non-governmental organization (NGO) personnel constituting membership of the NIH-sponsored Adolescent HIV Prevention and Treatment Implementation Science Alliance responded to the question: “In your experience, what factors have facilitated or hindered implementation of evidence-based HIV prevention or treatment for adolescents in sub-Saharan Africa?” Participants generated statements in response to the focus question, sorted them into thematically relevant groups, and rated each statement on its importance and changeability. Results Through data analyses and participant feedback, 15 distinct themes were derived. “Workforce/Workflow” and “HIV Stigma and Adolescent Development” were rated highest for importance, and “Threshold Conditions for Treatment” and “Structure of Implementation Efforts” were rated most changeable. Conclusions Understanding implementation science determinants and mechanisms can facilitate the uptake of successful implementation and sustainment strategies for the prevention and treatment of HIV in a given context. We placed determinants and mechanisms within the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to provide greater contextual integration with broader theories in implementation science. Implementers across multiple disciplines can use these findings to improve the scale-up of evidence-based practices for adolescent HIV prevention and treatment in sub-Saharan Africa. Implementation approaches that consider the determinants and mechanisms identified in this study and integrated in implementation frameworks will likely have utility for other health conditions and contexts.

Download Full-text

Training registered nurses to conduct pre-implementation assessment to inform program scale-up: an example from the rural Transitions Nurse Program

Implementation Science Communications ◽

10.1186/s43058-021-00127-8 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Chelsea Leonard ◽

Heather Gilmartin ◽

Marina McCreight ◽

Lynette Kelley ◽

Ashlea Mayberry ◽

...

Keyword(s):

Data Collection ◽

Implementation Strategy ◽

Care Transitions ◽

Scale Up ◽

Barriers And Facilitators ◽

Local Context ◽

Successful Implementation ◽

Evidence Based ◽

Local Contexts ◽

Implementation Assessment

Abstract Objectives Adapting evidence-based practices to local settings is critical for successful implementation and dissemination. A pre-implementation assessment evaluates local context to inform implementation, but there is little published guidance for clinician-implementers. The rural Transitions Nurse Program (TNP) is a care coordination intervention that facilitates care transitions for rural veterans. In year 1 of TNP, pre-implementation assessments were conducted by a centralized project team through multi-day visits at five sites nationwide. In year 2, we tested if local site TNP nurses could conduct pre-implementation assessments using evidence-based tools and coaching from the TNP team. This required developing a multicomponent pre-implementation strategy bundle to guide data collection and synthesis. We hypothesized that (1) nurses would find the pre-implementation assessment useful for tailoring TNP to local contexts and (2) nurses would identify similar barriers and facilitators to those identified at first year sites. Methods The bundle included guides for conducting key informant interviews, brainwriting, process mapping, and reflective journaling. We evaluated TNP nurse satisfaction and perceived utility of the structure and process of the training and bundle through pre-post surveys. To assess the outcome of data collection efforts, we interviewed nurses 4 months after completion of the pre-implementation assessment to determine if and how they used pre-implementation findings to tailor implementation of TNP to local contexts. To further assess outcomes, all data that the nurses collected were analyzed thematically. Themes related to barriers and facilitators were compared across years. Findings Five nurses at different VA medical centers used the pre-implementation strategy bundle to collect site-level data and completed pre-post surveys. Findings indicated that the pre-implementation assessment was highly recommended, and the bundle provided adequate training. Nurses felt that pre-implementation work oriented them to the local context and illustrated how to integrate TNP into existing processes. Barriers and facilitators identified by nurses were similar to those collected in year 1 by the TNP research team, including communication challenges, need for buy-in, and logistical concerns. Conclusions This proof-of-concept study suggests that evidence-based tools can effectively guide clinician-implementers through the process of conducting a pre-implementation assessment. This approach positively informed TNP implementation and oriented nurses to their local context prior to implementation.

Download Full-text

Implementation of artificial intelligence (AI) applications in radiology: hindering and facilitating factors

European Radiology ◽

10.1007/s00330-020-06946-y ◽

2020 ◽

Vol 30 (10) ◽

pp. 5525-5532

Author(s):

Lea Strohm ◽

Charisma Hehakaya ◽

Erik R. Ranschaert ◽

Wouter P. C. Boon ◽

Ellen H. M. Moors

Keyword(s):

Artificial Intelligence ◽

Scale Up ◽

Barriers And Facilitators ◽

Added Value ◽

Successful Implementation ◽

Structured Interviews ◽

Implementation Processes ◽

Technical Performance ◽

Facilitating Factors ◽

Clinical Radiology

Abstract Objective The objective was to identify barriers and facilitators to the implementation of artificial intelligence (AI) applications in clinical radiology in The Netherlands. Materials and methods Using an embedded multiple case study, an exploratory, qualitative research design was followed. Data collection consisted of 24 semi-structured interviews from seven Dutch hospitals. The analysis of barriers and facilitators was guided by the recently published Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework for new medical technologies in healthcare organizations. Results Among the most important facilitating factors for implementation were the following: (i) pressure for cost containment in the Dutch healthcare system, (ii) high expectations of AI’s potential added value, (iii) presence of hospital-wide innovation strategies, and (iv) presence of a “local champion.” Among the most prominent hindering factors were the following: (i) inconsistent technical performance of AI applications, (ii) unstructured implementation processes, (iii) uncertain added value for clinical practice of AI applications, and (iv) large variance in acceptance and trust of direct (the radiologists) and indirect (the referring clinicians) adopters. Conclusion In order for AI applications to contribute to the improvement of the quality and efficiency of clinical radiology, implementation processes need to be carried out in a structured manner, thereby providing evidence on the clinical added value of AI applications. Key Points • Successful implementation of AI in radiology requires collaboration between radiologists and referring clinicians. • Implementation of AI in radiology is facilitated by the presence of a local champion. • Evidence on the clinical added value of AI in radiology is needed for successful implementation.

Download Full-text

The Importance of Mental Models in Implementation Science

10.21203/rs.3.rs-21811/v1 ◽

2020 ◽

Author(s):

Jodi Summers Holtrop ◽

Laura Scherer ◽

Daniel Matlock ◽

Russell E Glasgow ◽

Lee A Green

Keyword(s):

Mental Models ◽

Implementation Science ◽

Cognitive Task ◽

Implementation Strategies ◽

Successful Implementation ◽

Evidence Based ◽

Structured Interviews ◽

Implementation Challenges ◽

The World ◽

The Way

Abstract Background: Implementation science is concerned with the study of adoption, implementation and maintenance of evidence-based interventions and use of implementation strategies to facilitate translation into practice. Ways to conceptualize and overcome challenges to implementing evidence-based practice may enhance the field of implementation science. The concept of mental models may be one way to view such challenges and to guide selection, use and adaptation of implementation strategies. Methods: A mental model is an interrelated set of beliefs that shape how a person forms expectations for the future and understands the way the world works. Mental models can shape how an individual thinks about or understands how something or someone does, can, or should function in the world. We review the concepts of mental models and illustrate how they pertain to implementation of an example intervention, shared decision making. A range of methods to elicit and analyze mental models are reviewed, including formal methods developed specifically for a given project. Results: Mental models may be sparse or detailed, may be shared among actors in implementation or not, and may be substantially tacit, i.e., of limited accessibility to introspection. Actors’ mental models can determine what information they are willing to accept and what changes they are willing to consider. We describe and illustrate multiple methods for eliciting and analyzing mental models including semi-structured interviews, cognitive task analyses and Delphi methods. Conclusions: Understanding the mental models of actors in implementation can provide crucial information for understanding, anticipating, and overcoming implementation challenges. Successful implementation often requires changing actors’ mental models or the way in which interventions or implementation strategies are presented or implemented. Accurate elicitation and understanding can guide strategies for doing so.

Download Full-text

Evaluation of the Implementation Process of the Mobile Health Platform ‘WelTel’ in Six Sites in East Africa and Canada Using the Modified Consolidated Framework for Implementation Research (mCFIR)

10.21203/rs.3.rs-110557/v1 ◽

2020 ◽

Author(s):

Samia El Joueidi ◽

Kevin Bardosh ◽

Richard Musoke ◽

Binyam Tilahun ◽

Maryam Abo Moslim ◽

...

Keyword(s):

Implementation Research ◽

Digital Health ◽

Descriptive Analysis ◽

Scale Up ◽

Implementation Process ◽

Evidence Based ◽

Structured Interviews ◽

User Friendliness ◽

Domain 3 ◽

And Performance

Abstract Background: Health systems globally are investing in integrating secure messaging platforms for virtual care in clinical practice. Implementation science is essential for adoption, scale-up, spread and maintenance of complex evidence-based solutions in clinics with evolving priorities. In response, the mHealth Research Group modified the existing Consolidated Framework for Implementation Research (mCFIR) to evaluate implementation of virtual health tools in clinical settings. WelTel® is an evidence-based digital health platform widely deployed in various geographical and health contexts. Objectives: To identify the facilitators and barriers for implementing WelTel and to assess the application of the mCFIR tool in facilitating focus groups in different geographical and health settings. Methodology: Both qualitative and semi-quantitative approaches were employed. Six mCFIR sessions were held in three countries with 51 key stakeholders surveyed. The mCFIR tool consists of 5 Domains and 25 Constructs and was built and distributed through Qualtrics XM. “Performance ” and “Importance” scores were valued on a scale of 0 to 10 (Mean + SD). Descriptive analysis was conducted using R computing software. NVivo 12 Pro software was used to analyze mCFIR responses and to generate themes from the participants’ input. Semi-structured interviews were conducted with the focus group facilitators to understand their experience using the mCFIR tool. Results: We observed a parallel trend in the scores for Importance and Performance. Of the five Domains, Domain 4 (End-user Characteristics) and Domain 3 (Inner Settings) scored highest in Importance (8.9 + 0.5 and 8.6 + 0.6, respectively) and Performance (7.6 + 0.7 and 7.2 + 1.3, respectively) for all sites. Domain 2 (Outer Setting) scored the lowest in both Importance and Performance for all sites (7.6 + 0.4 and 5.6 + 1.8). Areas of strengths included timely diagnosis, immediate response, cost-effectiveness, user-friendliness, and simplicity. Areas for improvement included training, phone accessibility, health authority’s engagement, and literacy. Conclusion: The mCFIR tool allowed for a comprehensive understanding of the barriers and facilitators to the implementation, reach, and scale-up of digital health tools. Participants emphasized the importance of creating partnerships with external organizations and health authorities in order to achieve sustainability and scalability.Trial Registration: · NCT02603536 – November 11, 2015· NCT01549457 – March 9, 2012

Download Full-text

Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice

Journal of Athletic Training ◽

10.4085/1062-6050-49.2.15 ◽

2014 ◽

Vol 49 (2) ◽

pp. 234-244 ◽

Cited By ~ 21

Author(s):

Cailee E. Welch ◽

Dorice A. Hankemeier ◽

Aimee L. Wyant ◽

Danica G. Hays ◽

William A. Pitney ◽

...

Keyword(s):

Clinical Practice ◽

Patient Care ◽

Athletic Training ◽

Health Care Professionals ◽

Evidence Based Practice ◽

Improve Patient Care ◽

Educational Interventions ◽

Successful Implementation ◽

Evidence Based ◽

Training Experience

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs and to determine successful strategies to implement EBP into didactic curricula and clinical practice. Additional focus should be given to which strategies most effectively produce changes in clinical practice.

Download Full-text

A Roadmap to Inform the Implementation of Evidence-Based Collaborative Care Interventions in Communities: Insights From the Michigan Mental Health Integration Partnership

10.21203/rs.3.rs-112875/v1 ◽

2020 ◽

Author(s):

Amy Rusch ◽

Lindsay DeCamp ◽

Celeste Liebrecht ◽

Seo Youn Choi ◽

Gregory W Dalack ◽

...

Keyword(s):

Mental Health ◽

Best Practices ◽

Collaborative Care ◽

Project Teams ◽

Successful Implementation ◽

Evidence Based ◽

Structured Interviews ◽

Community Based ◽

Mental Health Integration ◽

Implementation Steps

Abstract BackgroundIn spite of increasing calls for further spread of evidence-based collaborative care interventions (EBIs) in community-based settings, practitioner-driven efforts are often stymied by a lack of experience in addressing barriers to community-based implementation, especially for those not familiar with implementation science. The Michigan Mental Health Integration Partnership (MIP) is a statewide initiative that funds projects that support implementation and uptake of EBIs in community-based settings. MIP also provides an in situ implementation laboratory for understanding barriers to the uptake of EBIs across a variety of settings. We report findings from a Statewide qualitative study of practitioners involved in MIP projects to garner their perspectives of best practices in the implementation of EBIs. MethodsTwenty-eight semi-structured interviews of practitioners and researchers from six MIP Projects were conducted with individuals implementing various MIP EBI projects across Michigan, including stakeholders from project teams, implementation sites, and the State of Michigan, to identify common barriers, challenges, and implementation strategies deployed by the project teams, with the purpose of informing a set of implementation steps and milestones. ResultsStakeholders identified a number of barriers to and strategies for success, including the need for tailoring program deployment and implementation to specific site needs, development of web-based tools for facilitating program implementation, and the importance of upper level administration buy-in. Findings informed our resultant community-based Implementation Roadmap, which identifies critical steps across three implementation phases--pre-implementation, implementation, and sustainability—for implementation practitioners to use in their EBI implementation efforts. ConclusionImplementation practitioners interested in community-based EBI implementation often lack access to operationalized implementation “steps” or “best practices” that can facilitate successful uptake and evaluation. Our community-informed MIP Implementation Roadmap, offering generalized steps for reaching successful implementation, uses experiences from a diverse set of MIP teams to guide practitioners through the practices necessary for scaling up EBIs in community-based settings over pre-implementation, implementation and sustainability phases.

Download Full-text