A process for developing an implementation intervention: QUERI Series

Curran, Geoffrey M.; Mukherjee, Snigda; Allee, Elise; Owen, Richard R.

doi:10.1186/1748-5908-3-17

Cited by 89 publications

(97 citation statements)

References 29 publications

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“…Having key stakeholders in a community-based organization who are invested in implementing an intervention and are active throughout the process ensures that the final product truly reflects the needs of the target population and addresses them effectively (Ottoson & Green, 2005). Participation in the development of interventions by the end users also promotes the adoption and sustainability of those efforts (Curran, Mukherjee, Allee, & Owen, 2008).…”

Section: Discussionmentioning

confidence: 99%

Addressing Health Disparities Through Patient Education: The Development of Culturally-Tailored Health Education Materials at Puentes de Salud

Harvey

O’Brien

2011

Journal of Community Health Nursing

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The availability of culturally appropriate written health information is essential for promoting health in diverse populations. Lack of English fluency has been shown to negatively impact health outcomes for Latinos in the United States. The authors conducted a needs assessment at a clinic serving Latino immigrants, focusing on patients' health and previous experiences with written health information. Based on these results and a literature review, we developed 10 Spanish language brochures to better serve the target population. This article outlines the process of developing and implementing this intervention, which can serve as a model for similar projects targeting diverse populations.

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Section: Discussionmentioning

confidence: 99%

Addressing Health Disparities Through Patient Education: The Development of Culturally-Tailored Health Education Materials at Puentes de Salud

Harvey

O’Brien

2011

Journal of Community Health Nursing

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“…15 These surveys and other research [16][17][18][19][20] suggest that clinician education about family history risk assessment is needed, along with increased awareness of existing genetic testing and referral guidelines. To address the need for clinician education and systems improvement, we developed an innovative multicomponent implementation strategy 21 in the form of a cancer genetics toolkit designed to improve familial risk assessment and appropriate referrals for HBOC and Lynch syndrome. The toolkit components were grouped as informational, clinical, and behavioral, mirroring a definition of continued medical education interventions, 22 because most experts agree that multifaceted interventions are preferable and necessary to change clinician behavior and improve patient outcomes.…”

Section: Without a Family History Of Endometrialmentioning

confidence: 99%

A cancer genetics toolkit improves access to genetic services through documentation and use of the family history by primary-care clinicians

Scheuner

Hamilton

Peredo

et al. 2014

Genetics in Medicine

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Purpose:We developed, implemented, and evaluated a multicomponent cancer genetics toolkit designed to improve recognition and appropriate referral of individuals at risk for hereditary cancer syndromes. Methods:We evaluated toolkit implementation in the women's clinics at a large Veterans Administration medical center using mixed methods, including pre-post semistructured interviews, clinician surveys, and chart reviews, and during implementation, monthly tracking of genetic consultation requests and use of a reminder in the electronic health record. We randomly sampled 10% of progress notes 6 months before (n = 139) and 18 months during implementation (n = 677). Results:The toolkit increased cancer family history documentation by almost 10% (26.6% pre-and 36.3% postimplementation). The reminder was a key component of the toolkit; when used, it was associated with a twofold increase in cancer family history documentation (odds ratio = 2.09; 95% confidence interval: 1.39-3.15), and the history was more complete. Patients whose clinicians completed the reminder were twice as likely to be referred for genetic consultation (4.1-9.6%, P < 0.0001). Conclusion:A multicomponent approach to the systematic collection and use of family history by primary-care clinicians increased access to genetic services.

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“…Several frameworks have been proposed to describe the factors that contribute to the implementation process (e.g., Curran et al, 2008; Damschroder et al; 2009; Glasgow, & Boles, 1999; Stetler, et al, 2008). Implementation fidelity is fundamental to these models.…”

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confidence: 99%

Observational Measures of Implementer Fidelity for a School-Based Preventive Intervention: Development, Reliability, and Validity

et al. 2014

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Current measures of implementer fidelity often fail to adequately measure core constructs of adherence and competence, and their relationship to outcomes can be mixed. To address these limitations, we used observational methods to assess these constructs and their relationships to proximal outcomes in a randomized trial of a school-based preventive intervention (Rochester Resilience Project) designed to strengthen emotion self-regulation skills in 1st–3rd graders with elevated aggressive-disruptive behaviors. Within the intervention group (n = 203), a subsample (n = 76) of students was selected to reflect the overall sample. Implementers were 10 paraprofessionals. Videotaped observations of three lessons from Year 1 of the intervention (14 lessons) were coded for each implementer-child dyad on Adherence (content) and Competence (quality). Using multi-level modeling we examined how much of the variance in the fidelity measures was attributed to implementer and to the child within implementer. Both measures had large and significant variance accounted for by implementer (Competence, 68%; Adherence, 41%); child within implementer did not account for significant variance indicating that ratings reflected stable qualities of the implementer rather than the child. Raw Adherence and Competence scores shared 46% of variance (r = .68). Controlling for baseline differences and age, the amount (Adherence) and quality (Competence) of program delivered predicted children’s enhanced response to the intervention on both child and parent reports after six months, but not on teacher report of externalizing behavior. Our findings support the use of multiple observations for measuring fidelity and that adherence and competence are important components of fidelity which could be assessed by many programs using these methods.

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A process for developing an implementation intervention: QUERI Series

Abstract: Background: This article describes the process used by the authors in developing an implementation intervention to assist VA substance use disorder clinics in adopting guideline-based practices for treating depression.

Cited by 89 publications

References 29 publications

Addressing Health Disparities Through Patient Education: The Development of Culturally-Tailored Health Education Materials at Puentes de Salud

Addressing Health Disparities Through Patient Education: The Development of Culturally-Tailored Health Education Materials at Puentes de Salud

A cancer genetics toolkit improves access to genetic services through documentation and use of the family history by primary-care clinicians

Observational Measures of Implementer Fidelity for a School-Based Preventive Intervention: Development, Reliability, and Validity

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