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Gold open access articles authored by UNC researchers and published by SAGE.
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201. Is implementation research out of step with implementation practice? Pathways to effective implementation support over the last decade
- Title Tesim:
- Is implementation research out of step with implementation practice? Pathways to effective implementation support over the last decade
- Creator:
- Farley, Amanda, Metz, Allison, Boaz, Annette, and Jensen, Todd
- Date of publication:
- June 6, 2022
- Abstract Tesim:
- Background: There is growing interest in the lived experience of professionals who provide implementation support (i.e., implementation support practitioners). However, there remains limited knowledge about their experiences and how those experiences can contribute to the knowledge base on what constitutes successful and sustainable implementation support models. This study aimed to examine pathways of implementation support practice, as described by experienced professionals actively supporting systems’ uptake and sustainment of evidence to benefit children and families. Methods: Seventeen individuals with extensive experience providing implementation support in various settings participated in semi-structured interviews. Data were analyzed using qualitative content analysis and episode profile analysis approaches. Iterative diagramming was used to visualize the various pathways of implementation support practitioners’ role reflection and transformation evidenced by the interview data. Results: Findings highlighted rich pathways of implementation support practitioners’ role reflection and transformation. Participants described their roots in providing implementation support as it relates to implementing and expanding the use of evidence-based programs and practices in child and family services. Almost all participants reflected on the early stages of their careers providing implementation support and described a trajectory starting with the use of “push models,” which evolved into “pull models” and eventually “co-creation or exchange models” of implementation support involving both technical and relational skills. Conclusions: Developing an implementation support workforce will require a deeper understanding of this lived experience to prevent repeated use of strategies observed to be unsuccessful by those most proximal to the work. The pathways for implementation practice in this study highlight impressive leaps forward in the field of implementation over the last 15 years and speaks to the importance of the professionals leading change efforts in this growth. Plain Language Summary Over the past few years, professionals in the field of implementation science have identified a growing gap between implementation research and implementation practice. While this issue has been highlighted informally, the field is lacking a shared understanding and clear way forward to reconcile this gap. In this paper, the authors describe how professionals providing implementation support have shifted their implementation practice over time through systematic observations of what works (and what does not work) for supporting and sustaining evidence use in service systems to improve population outcomes. The authors share the impressive leaps forward made in the field of implementation practice – from didactic training to responsive and tailored implementation strategies to co-created and relationship-based implementation solutions. The paper concludes with a call to action to the field for the creation of a virtuous learning cycle between professionals conducting implementation research and professionals providing implementation support to change practice as a way to produce a more robust and relevant science of implementation.
- Resource type:
- Article
- Affiliation Label Tesim:
- School of Social Work
- Copyright Date:
- 2022
- Deposit Record:
- 06aca227-c049-40f2-9cc9-135fb82707e8
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/rjfm-sq63
- Identifier:
- https://doi.org/10.1177/26334895221105585
- ISSN:
- 2633-4895
- Journal Title:
- Implementation Research and Practice
- Journal Volume:
- 3
- Keyword:
- implementation supports, evidence-based, implementation, and implementation practice
- License Label:
- Attribution 4.0 International
- ORCID:
- and https://orcid.org/0000-0002-0369-7021
- Other Affiliation:
- and Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine
- Person:
- Farley, Amanda, Metz, Allison, Boaz, Annette, and Jensen, Todd
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications Ltd and the Society for Implementation Research Colloboration, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
- Rights Statement Label:
- In Copyright
202. Barriers to recruiting primary care practices for implementation research during COVID-19: A qualitative study of practice coaches from the Stop Unhealthy (STUN) Alcohol Use Now trial
- Title Tesim:
- Barriers to recruiting primary care practices for implementation research during COVID-19: A qualitative study of practice coaches from the Stop Unhealthy (STUN) Alcohol Use Now trial
- Creator:
- Balio, Casey P., Barclay, Colleen, Riley, Sean R., Weathington, Chris, Jonas, Daniel E., and Grammer, Debbie
- Date of publication:
- April 24, 2022
- Abstract Tesim:
- Background: The COVID-19 pandemic has brought widespread change to health care practice and research. With heightened stress in the general population, increased unhealthy alcohol use, and added pressures on primary care practices, comes the need to better understand how we can continue practice-based research and address public health priorities amid the ongoing pandemic. The current study considers barriers and facilitators to conducting such research, especially during the COVID-19 pandemic, within the context of recruiting practices for the STop UNhealthy (STUN) Alcohol Use Now trial. The STUN trial uses practice facilitation to implement screening and interventions for unhealthy alcohol use in primary care practices across the state of North Carolina. Methods: Semistructured interviews were conducted with a purposive sample of 15 practice coaches to discuss their recruitment experiences before and after recruitment was paused due to the pandemic. An inductive thematic analysis was used to identify themes and subthemes. Results: Pandemic-related barriers, including challenges in staffing, finances, and new COVID-19-related workflows, were most prominent. Competing priorities, such as quality improvement measures, North Carolina's implementation of Medicaid managed care, and organizational structures hampered recruitment efforts. Coaches also described barriers specific to the project and to the topic of alcohol. Several facilitators were identified, including the rising importance of behavioral health due to the pandemic, as well as existing relationships between practice coaches and practices. Conclusions: Difficulty managing competing priorities and obstacles within existing practice infrastructure inhibit the ability to participate in practice-based research and implementation of evidence-based practices. Lessons learned from this trial may inform strategies to recruit practices into research and to gain buy-in from practices in adopting evidence-based practices more generally. Plain Language Summary What is known: Unhealthy alcohol use is a significant public health issue, which has been exacerbated during the COVID-19 pandemic. Screening and brief intervention for unhealthy alcohol use is an evidence-based practice shown to help reduce drinking-related behaviors, yet it remains rare in practice. What this study adds: Using a qualitative approach, we identify barriers and facilitators to recruiting primary care practices into a funded trial that uses practice facilitation to address unhealthy alcohol use. We identify general insights as well as those specific to the COVID-19 pandemic. Barriers are primarily related to competing priorities, incentives, and lack of infrastructure. Facilitators are related to framing of the project and the anticipated level and type of resources needed to address unhealthy alcohol use especially as the pandemic wanes. Implications: Our findings provide information on barriers and facilitators to recruiting primary care practices for behavioral health projects and to implementing these activities. Using our findings, we provide a discussion of suggestions for conducting these types of projects in the future which may be of interest to researchers, practice managers, and providers.
- Resource type:
- Article
- Affiliation Label Tesim:
- Cecil G. Sheps Center for Health Services Research and University of North Carolina at Chapel Hill
- Copyright Date:
- 2022
- Deposit Record:
- 06aca227-c049-40f2-9cc9-135fb82707e8
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/77xz-f647
- Identifier:
- https://doi.org/10.1177/26334895221094297
- ISSN:
- 2633-4895
- Journal Title:
- Implementation Research and Practice
- Journal Volume:
- 3
- Keyword:
- stages of implementation, implementation initiative < implementation, quality improvement, practice context, behavioral health < service system, and coaching
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- https://orcid.org/0000-0002-2987-4268 and
- Other Affiliation:
- Center for Rural Health Research, East Tennessee State University, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, , and North Carolina Area Health Education Centers
- Person:
- Balio, Casey P., Barclay, Colleen, Riley, Sean R., Weathington, Chris, Jonas, Daniel E., and Grammer, Debbie
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications Ltd and the Society for Implementation Research Colloboration, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
- Rights Statement Label:
- In Copyright
203. A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study
- Title Tesim:
- A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study
- Creator:
- Gizlice, Ziya, Leeman, Jennifer, Erskine, Amber, Allgood, Sallie D., Bunton, Audrina J., Samuel-Hodge, Carmen D., and Cykert, Samuel
- Date of publication:
- July 2022
- Abstract Tesim:
- Purpose To evaluate the implementation and effectiveness of the Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program, an adapted evidence-based cardiovascular disease risk reduction intervention delivered by Community Health Workers (CHW) to rural adults. Design Hybrid implementation-effectiveness study with a pre–post design. Setting North Carolina Federally Qualified Health Center and local health department in a rural, medically underserved area. Sample Participants (n = 255) included 87% Non-Hispanic Black with a mean age of 57 years; 84% had diagnosed hypertension, 55% had diabetes, and 65% had hypercholesterolemia. Intervention A CHW-delivered, low-intensity, 4-month behavioral lifestyle intervention promoting a southern-style Mediterranean dietary pattern and physical activity. Measures We measured number and representativeness of participants reached and retained, intervention delivery fidelity, weight, blood pressure, and self-reported dietary and physical activity behaviors. Analysis Pre–post changes at 4 months were analyzed using paired t-tests. Results Study participants completed 90% of planned intervention contacts; 87% were retained. Intervention delivery fidelity measures showed participants receiving a mean of 3.5 counseling visits, 2.7 booster calls, and on average completing 1.7 modules, setting 1.8 goals, and receiving 1.3 referrals per visit. There were significant mean reductions in systolic (−2.5 mmHg, P < .05) and diastolic blood pressure (−2.1 mmHg, P < .01); the proportion of participants with systolic blood pressure <130 increased by 7 % points (P = .05), and diastolic pressure <80 by 9 percentage points (P < .01). Dietary behaviors improved significantly with average weekly servings of nuts increased by .5 serving (P < .0001), and fruits and vegetables by .8 daily serving (P < .0001). Physical activity also increased on average by 45 min./week (P < .001). Weight did not change significantly. Conclusions The CHANGE program showed both implementation and program effectiveness and adds to the evidence supporting CHW-delivered lifestyle interventions to reduce CVD risk among rural, Non-Hispanic Black, and medically underserved populations.
- Resource type:
- Article
- Affiliation Label Tesim:
- UNC Center for Health Promotion and Disease Prevention, School of Nursing, Cecil G. Sheps Center for Health Services Research, Department of Nutrition, and Division of General Medicine and Clinical Epidemiology
- Copyright Date:
- 2022
- Deposit Record:
- 06aca227-c049-40f2-9cc9-135fb82707e8
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/exnh-0174
- Identifier:
- https://doi.org/10.1177/08901171221078272
- ISSN:
- 0890-1171
- Journal Issue:
- 6
- Journal Title:
- American Journal of Health Promotion
- Journal Volume:
- 36
- Keyword:
- prevention and control, Non-Hispanic Black, lay health advisors, rural health services, and lifestyle intervention
- License Label:
- Attribution 4.0 International
- ORCID:
- , https://orcid.org/0000-0002-0329-4572, and https://orcid.org/0000-0002-3700-7578
- Other Affiliation:
- , School of Nursing, Duke University, and Center for Promotion and Disease Prevention, University of North Carolina at Chapel Hill
- Page End:
- 958
- Page Start:
- 948
- Person:
- Gizlice, Ziya, Leeman, Jennifer, Erskine, Amber, Allgood, Sallie D., Bunton, Audrina J., Samuel-Hodge, Carmen D., and Cykert, Samuel
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications
- Rights Statement Label:
- In Copyright
204. The Effects of Park-Based Interventions on Health-Related Outcomes Among Youth: A Systematic Review
- Title Tesim:
- The Effects of Park-Based Interventions on Health-Related Outcomes Among Youth: A Systematic Review
- Creator:
- Derose, Kathryn P., Han, Bing, Wallace, Deshira D., and Cohen, Deborah A.
- Date of publication:
- July 2022
- Abstract Tesim:
- Objective The purpose of the study is to present a comprehensive systematic review of the effects of park-based interventions on health outcomes among youth, defined as children and adolescents. Data Source Web of Science, MEDLINE, and Scopus databases searched through November 2020.Study Inclusion and Exclusion Criteria Interventions conducted in publicly accessible parks that evaluated health outcomes (i.e., physical, mental, and emotional); focused on children and adolescents (up to 18 years old, or up to 22 years old for individuals with developmental needs); and was published in English, Spanish, and Chinese. Data Extraction Two independent reviewers extracted data and assessed the quality of the 15 included studies using the Guide to Community Preventive Services tool. Data Synthesis Descriptive summary of study characteristics and summarized methodological quality of the studies. Results Twelve studies were person-based interventions involving the evaluation of health outcome changes in cohorts, and the remaining studies were park-based, focused on changing the park environment and observing changes in youth participation in parks. All identified interventions were positively associated with individual-level and park-level outcomes ranging from body weight, moderate-to-vigorous-intensity physical activity, park utilization, and health behavior knowledge. Conclusions This systematic review demonstrated that parks as sites of interventions can provide an environment that promotes health and wellbeing for youth. Nevertheless, the number of relevant studies were limited, thus it is important to leverage and expand on existing knowledge of the utility of parks as sites of intervention to address health concerns at this critical juncture of the life course.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Health Behavior
- Copyright Date:
- 2022
- Deposit Record:
- 06aca227-c049-40f2-9cc9-135fb82707e8
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/7vkg-2k70
- Identifier:
- https://doi.org/10.1177/08901171221077812
- ISSN:
- 0890-1171
- Journal Issue:
- 6
- Journal Title:
- American Journal of Health Promotion
- Journal Volume:
- 36
- Keyword:
- systematic review, health outcomes, youth, parks, physical activity, and interventions
- License Label:
- Attribution 4.0 International
- ORCID:
- https://orcid.org/0000-0001-7742-6024, , and https://orcid.org/0000-0003-1300-6957
- Other Affiliation:
- RAND Corporation and
- Page End:
- 1044
- Page Start:
- 1029
- Person:
- Derose, Kathryn P., Han, Bing, Wallace, Deshira D., and Cohen, Deborah A.
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications
- Rights Statement Label:
- In Copyright
205. Clinical relevance of Tai Chi on pain and physical function in adults with knee osteoarthritis: An ancillary meta-analysis of randomized controlled trials
- Title Tesim:
- Clinical relevance of Tai Chi on pain and physical function in adults with knee osteoarthritis: An ancillary meta-analysis of randomized controlled trials
- Creator:
- Kelley, Kristi S, Callahan, Leigh F, and Kelley, George A
- Date of publication:
- April 5, 2022
- Abstract Tesim:
- The clinical relevance of Tai Chi on pain, stiffness, and physical function in adults with knee osteoarthritis (KOA) has not been established. Therefore, the purpose of the current study was to address this gap. Eight randomized controlled trials from a recent meta-analysis representing 407 participants (216 Tai Chi, 191 control) in adults ≥18 years of age with KOA and included the assessment of pain, stiffness, and physical function using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were assessed. The inverse variance heterogeneity model (IVhet) was first used to pool standardized mean difference effect sizes (ES) for each outcome. Clinical relevance, i.e., number-needed-to treat (NNT) ≤10 and relative risk reduction (RRR) ≥25% was calculated across assumed controlled risks (ACR) ranging from 0.01 to 0.99. Statistically significant improvements were found for pain (ES, −0.75, 95% CI, −0.99, −0.51; Q = 8.9, p = 0.26; I2 = 21%), stiffness (ES, −0.70, 95% CI, −0.95, −0.46; Q = 9.6, p = 0.21; I2 = 27%), and physical function (ES, −0.91, 95% CI, −1.12, −0.70; Q = 7.2, p = 0.40; I2 = 3%). The intersection of results for a NNT ≤10 and RRR ≥25% yielded high evidence and clinically relevant improvements across a wide range of ACR for pain (0.15 to 0.88), stiffness (0.15 to 0.87), and physical function (0.13 to 0.97). These findings suggest that Tai Chi results in statistically significant as well as clinically important improvements in pain, stiffness, and physical function across a wide range of ACR in adults with KOA.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Epidemiology
- Copyright Date:
- 2022
- Deposit Record:
- f3be55ed-ddf0-44ad-beab-d18fd295bdbe
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/c9wg-7390
- Identifier:
- https://doi.org/10.1177/00368504221088375
- ISSN:
- 2047-7163
- Journal Issue:
- 2
- Journal Title:
- Science Progress
- Journal Volume:
- 105
- Keyword:
- aging, Tai Chi, osteoarthritis, older adults, and meta-analysis
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0003-0595-4148
- Other Affiliation:
- Department of Epidemiology and Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA and
- Person:
- Kelley, Kristi S, Callahan, Leigh F, and Kelley, George A
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications
- Rights Statement Label:
- In Copyright
206. Unstable Identities: The Decline of Partisanship in Contemporary Chile
- Title Tesim:
- Unstable Identities: The Decline of Partisanship in Contemporary Chile
- Creator:
- de la Cerda, Nicolás
- Date of publication:
- April 2022
- Abstract Tesim:
- Between 1990 and 2018 Chile experienced one of Latin America’s most dramatic declines in party identification, from 80% in the early 1990s to under 20% in 2016. This decline seems puzzling given a highly institutionalized and programmatic party system, and low levels of ideological convergence. This paper argues that, to a large extent, the decrease in partisanship can be understood as a consequence of the erosion of the main political cleavage that articulated the political landscape throughout this period: the dissolution of the conflict between the supporters of the previous military regime (1973–1990) and the advocates of democracy. Because this conflict was the key driver of political identities following the dictatorship, as it faded overtime, particularly after conservative parties distanced themselves from the military regime for electoral reasons, partisans lost an important reason to feel attached to political parties. More broadly, the paper argues that unless political identities are continually reinforced by political actors, they are unlikely to remain stable sources of identification.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Political Science
- Copyright Date:
- 2022
- Deposit Record:
- f3be55ed-ddf0-44ad-beab-d18fd295bdbe
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/803p-a828
- Identifier:
- https://doi.org/10.1177/1866802X211069378
- ISSN:
- 1866-802X and 1868-4890
- Journal Issue:
- 1
- Journal Title:
- Journal of Politics in Latin America
- Journal Volume:
- 14
- Keyword:
- Latin America, Chile, Party identification, and political identities
- License Label:
- Attribution 4.0 International
- ORCID:
- https://orcid.org/0000-0003-2474-9756
- Other Affiliation:
- Page End:
- 30
- Page Start:
- 3
- Person:
- de la Cerda, Nicolás
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications Ltd, or GIGA German Institute of Global and Area Studies, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
- Rights Statement Label:
- In Copyright
207. Digital Health Experiences of Incarcerated Populations Using Telemedicine in North Carolina Prisons
- Title Tesim:
- Digital Health Experiences of Incarcerated Populations Using Telemedicine in North Carolina Prisons
- Creator:
- Catlett, Terri, Zebrowski, Ashlyn, Wallace, Erin, Khairat, Saif, Yao, Yuxiao, Stabile, Kaitlyn, Edson, Barbara, Lakdawala, Adnan, and Bohlmann, Aaron
- Date of publication:
- April 19, 2022
- Abstract Tesim:
- More than 1.2 million adults are incarcerated in the United States and hence, require health care from prison systems. The current delivery of care to incarcerated individualss is expensive, logistically challenging, risk fragmenting care, and pose security risks. The purpose of this study was to evaluate the association of patient characteristics and experiences with the perceived telemedicine experiences of incarcerated individuals during the pandemic. We conducted a cross-sectional study of incarcerated individuals in 55 North Carolina prison facilities seeking medical specialty care via telemedicine. Data collection took place from June 1, 2020 to November 30, 2020. Of the 482 patient surveys completed, 424 (88%) were male, 257 (53.3%) were over 50 years of age, and 225 (46.7%) were Black or African American and 195 (40.5%) were White, and 289 (60%) no prior telemedicine experience. There were 3 strong predictors of how patients rated their telemedicine experience: personal comfort with telemedicine (P-value < .001), wait time (P-value < .001), and the clarity of the treatment explanation by the provider (P-value < .001). There was a relationship between telemedicine experiences and how patient rated their experience. Also, patients who were less satisfied with using telemedicine indicated their preference for an in-clinic visit for their next appointment.
- Resource type:
- Article
- Copyright Date:
- 2022
- Deposit Record:
- f3be55ed-ddf0-44ad-beab-d18fd295bdbe
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/zawr-hx83
- Identifier:
- https://doi.org/10.1177/23743735221092611
- ISSN:
- 2374-3743
- Journal Title:
- Journal of Patient Experience
- Journal Volume:
- 9
- Keyword:
- evaluation, implementation, cost, prisons, benefit, and telemedicine
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0002-8992-2946
- Other Affiliation:
- Healthcare Administration, North Carolina Department of Public Safety, NC, USA, Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA, School of Information and Library Science, University of North Carolina at Chapel Hill, NC, USA, and UNC Health, NC, USA
- Person:
- Catlett, Terri, Zebrowski, Ashlyn, Wallace, Erin, Khairat, Saif, Yao, Yuxiao, Stabile, Kaitlyn, Edson, Barbara, Lakdawala, Adnan, and Bohlmann, Aaron
- Publisher:
- SAGE Publications
- Rights Holder:
- Association for Patient Experience
- Rights Statement Label:
- In Copyright
208. Developing and applying synergistic multilevel implementation strategies to promote reach of an evidence-based parenting intervention in primary care
- Title Tesim:
- Developing and applying synergistic multilevel implementation strategies to promote reach of an evidence-based parenting intervention in primary care
- Creator:
- Bigal, Luisa, Powell, Byron J., and Schilling, Samantha
- Date of publication:
- April 13, 2022
- Abstract Tesim:
- Background: This practical implementation report describes a primary care-based group parenting intervention—Child–Adult Relationship Enhancement in Primary Care (PriCARE)—and the approach taken to understand and strengthen the referral process for PriCARE within a pediatric primary care clinic through the deployment of synergistic implementation strategies to promote physician referrals. PriCARE has evidence of effectiveness for reducing child behavior problems, harsh and permissive parenting, and parent stress from three randomized controlled trials (RCTs). The integration of evidence-based parenting interventions into pediatric primary care is a promising means for widespread dissemination. Yet, even when integrated into this setting, the true reach will depend on parents knowing about and attending the intervention. A key factor in this process is the endorsement of and referral to the intervention by the child's pediatrician. Therefore, identifying strategies to improve physician referrals to parenting interventions embedded in primary care is worthy of investigation. Method: Through lessons learned from the RCTs and key informant interviews with stakeholders, we identified barriers and facilitators to physician referrals of eligible parent–child dyads to PriCARE. Based on this data, we selected and implemented five strategies to increase the PriCARE referral rate. We outline the selection process, the postulated synergistic interactions, and the results of these efforts. Conclusions: The following five discrete strategies were implemented: physician reminders, direct advertising to patients, incentives/public recognition, interpersonal patient narratives, and audit and feedback. These discrete strategies were synergistically combined to create a multifaceted approach to improve physician referrals. Following implementation, referrals increased from 13% to 55%. Continued development, application, and evaluation of implementation strategies to promote the uptake of evidence-based parenting interventions into general use in the primary care setting are discussed. Plain Language Summary There is strong evidence that parenting interventions are effective at improving child behavioral health outcomes when delivered in coordination with pediatric primary care. However, there is a lack of focus on the implementation, including the screening and referral process, of parenting interventions in the primary care setting. This is contributing to the delay in the scale-up of parenting interventions and to achieving public health impact. To address this gap, we identified barriers and facilitators to physician screening and referrals to a primary care-based parenting intervention, and selected and piloted five synergistic strategies to improve this critical process. This effort successfully increased physician referrals of eligible patients to the intervention from 13% to 55%. This demonstration project may help advance the implementation of evidence-based interventions by providing an example of how to develop and execute multilevel strategies to improve intervention referrals in a local context.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Pediatrics
- Copyright Date:
- 2022
- Deposit Record:
- f3be55ed-ddf0-44ad-beab-d18fd295bdbe
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/2ka3-0b80
- Identifier:
- https://doi.org/10.1177/26334895221091219
- ISSN:
- 2633-4895
- Journal Title:
- Implementation Research and Practice
- Journal Volume:
- 3
- Keyword:
- implementation barriers, multilevel implementation strategies, implementation, parenting intervention, and pediatric primary care
- License Label:
- Attribution 4.0 International
- ORCID:
- and https://orcid.org/0000-0001-5245-1186
- Other Affiliation:
- and Center for Mental Health Services Research, Brown School and School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
- Person:
- Bigal, Luisa, Powell, Byron J., and Schilling, Samantha
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications Ltd and the Society for Implementation Research Colloboration, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
- Rights Statement Label:
- In Copyright
209. Coming Full Circle: Reflections and Inspirations from a Cystic Fibrosis Patient Scientist Panel
- Title Tesim:
- Coming Full Circle: Reflections and Inspirations from a Cystic Fibrosis Patient Scientist Panel
- Creator:
- Figueira, Miriam F., Nowakowski, Alexandra “Xan” C. H., Lawlor, James M. J., Balasa, Gabriella “Ella”, and LaRosa, Francis “Tré” J.
- Date of publication:
- April 14, 2022
- Abstract Tesim:
- Care for many progressive chronic diseases continues to improve, allowing patients to survive and thrive for longer periods of time1. People living with such conditions may now find themselves able to achieve long-term goals in education and career development2. Many people now occupy the dual roles of scientist and patient3. This commentary article synthesizes experiences of scientists and advocates with the progressive genetic disease cystic fibrosis (CF) who collaborated on a career development session for the Cystic Fibrosis Foundation’s inaugural ResearchCon event in 2019. It explores how such collaborations affirm and transform individual perspectives on patient science and its importance in broader scientific research agenda setting. We first share our own individual insights about the experience and impact of the ResearchCon panel session before progressing to discussion and future directions centering the shared insights from one another’s reflections.
- Resource type:
- Article
- Affiliation Label Tesim:
- Cystic Fibrosis and Pulmonary Diseases Research and Treatment Center
- Copyright Date:
- 2022
- Deposit Record:
- f3be55ed-ddf0-44ad-beab-d18fd295bdbe
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/1n3r-fs14
- Identifier:
- https://doi.org/10.1177/00469580221086921
- ISSN:
- 0046-9580 and 1945-7243
- Journal Title:
- INQUIRY: The Journal of Health Care Organization, Provision, and Financing
- Journal Volume:
- 59
- Keyword:
- professional collaboration, cystic fibrosis, career development, patient voices, and scientific research
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0002-9072-2482
- Other Affiliation:
- , Florida State University College of Medicine, Director, United States Adult Cystic Fibrosis Association, Orlando, FL, USA, HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA, United States Adult Cystic Fibrosis Association, Richmond, VA, USA, and BioNews Insights, Washington, DC, USA
- Person:
- Figueira, Miriam F., Nowakowski, Alexandra “Xan” C. H., Lawlor, James M. J., Balasa, Gabriella “Ella”, and LaRosa, Francis “Tré” J.
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications
- Rights Statement Label:
- In Copyright
210. Using WhatsApp Focus Group Discussions to Collect Qualitative Data Collection During a Pandemic: Exploring Knowledge, Attitudes, and Perceptions of COVID-19 in Singapore
- Title Tesim:
- Using WhatsApp Focus Group Discussions to Collect Qualitative Data Collection During a Pandemic: Exploring Knowledge, Attitudes, and Perceptions of COVID-19 in Singapore
- Creator:
- Neo, Pearlyn HM, Ong, Suan Ee, Tan, Rayner KJ, and Lim, Jane M
- Date of publication:
- April 10, 2022
- Abstract Tesim:
- This qualitative study aimed to explore Singapore residents’ knowledge, attitudes, perceptions, and behaviors around COVID-19 as shaped by different information sources. Through utilizing WhatsApp as a means of conducting digital focus group discussions (FGDs), participants were involved in five consecutive days of discussions through both synchronous and asynchronous means. We found that the use of WhatsApp as a means of conducting FGDs not only served as a means of generating essential, time-sensitive data in the community, but also advanced the quality and quantity of data generated, democratized, and enhanced the participatory nature of FGDs, and facilitated the communication of potential issues around data privacy between facilitators and participants. Although challenges around privacy and confidentiality remain, this means of collecting data is novel in terms of providing timely and relevant data during a pandemic and would be appropriate to be further utilized in the context of other health-related research beyond a public health emergency.
- Resource type:
- Article
- Affiliation Label Tesim:
- UNC Project-China
- Copyright Date:
- 2022
- Deposit Record:
- f3be55ed-ddf0-44ad-beab-d18fd295bdbe
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/yv0k-6k58
- Identifier:
- https://doi.org/10.1177/16094069221090355
- ISSN:
- 1609-4069
- Journal Title:
- International Journal of Qualitative Methods
- Journal Volume:
- 21
- Keyword:
- COVID-19, qualitative methodology, Asia/Southeast Asia/Singapore, health behaviors, digital data collection, focus groups, and health information
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- https://orcid.org/0000-0002-7797-8942 and
- Other Affiliation:
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Person:
- Neo, Pearlyn HM, Ong, Suan Ee, Tan, Rayner KJ, and Lim, Jane M
- Publisher:
- SAGE Publications
- Rights Holder:
- International Institute for Qualitative Methodology at the University of Alberta, Canada
- Rights Statement Label:
- In Copyright
Collection Details
- Total items
-
422
- Size
-
unknown
- Date created
-
February 2, 2022