Search for a Practical Strategy to Disseminate Models of Advanced Preventive Care that Improve the Health of Chronically Ill Older Adults Public Deposited

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  • March 21, 2019
  • Coburn, Kenneth
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Developing new, more effective models of preventive care for an aging, chronically ill population is an important public health imperative. New models that provide more frequent and ongoing monitoring and assessments coupled with personalized preventive interventions are emerging. Such models of “advanced preventive care” are operationally demanding and costly to implement. Even when they improve health outcomes and reduce net health care expenditures, there are several barriers to the spread of such models and no guarantee they will come into widespread use. Little research has been undertaken to assess the role that innovators of new care models might play in facilitating their dissemination. The theoretical framework of Greenhalgh et al. helps conceptualize the position innovators hold relative to other entities involved in dissemination, but leaves unanswered the question of what direct actions innovators might take to facilitate dissemination (2008). Using an exemplar advanced preventive care program as a reference point, sixteen health care executives from hospital (n=12) and physician organizations (n=4) were interviewed regarding their level of interest in providing such a program to their service populations. Informants were asked about three types of collaborations with the program’s developers to support their organization’s use of the program; direct service partnership, franchising, or regional cooperative. The research yielded a new model of collaborative partnership, replication consultancy, that would provide more robust support for the adoption and assimilation of advanced preventive care than typical consulting or knowledge purveyor offerings without institutionalizing long-term dependency on program developers. The direct service partnership model that the originators of the exemplar model have relied on for years in their local service area, also appears to be a viable option to support broader dissemination among hospital organizations. In some settings, potential adopters were interested in franchise and regional cooperative models with the only model viewed favorably by the small number of physician organizations in the study being the regional cooperative (2 out of 4). These results inform an implementation plan program developers can use to further the dissemination of advanced preventive care and highlight opportunities for health policy to help advance this important public health imperative.
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Rights statement
  • In Copyright
  • Greene, Sandra
  • Leatherman, Sheila
  • Wade, Torlen
  • Ricketts, Thomas C.
  • Weinberger, Morris
  • Doctor of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016

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