Measurement of sustainment of prevention programs and initiatives: the sustainment measurement system scale

Palinkas, Lawrence A.; Chou, Chih Ping; Spear, Suzanne E.; Mendon, Sapna J.; Villamar, Juan A.; Brown, C. Hendricks

doi:10.1186/s13012-020-01030-x

Cited by 29 publications

(31 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Programs that are not kept up after an initial investment can waste money and nonmonetary resources [5,6]. Having a better understanding of what factors affect sustainability can inform strategies to improve the likelihood that interventions will successfully continue after initial implementation [7,8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Clinical Sustainability Assessment Tool: measuring organizational capacity to promote sustainability in healthcare

Malone

Prewitt

Hackett

et al. 2021

Implement Sci Commun

View full text Add to dashboard Cite

Background Few validated assessment tools are available to increase understanding and measure factors associated with sustainment of clinical practices, an increasingly recognized need among clinicians. We describe the development of the Clinical Sustainability Assessment Tool (CSAT), designed to assess factors that contribute to sustainable practices in clinical settings. Methods Sixty-four participants from clinical and research fields participated in concept mapping and were recruited to brainstorm factors that lead to sustained clinical practices. Once repeated factors were removed, participants sorted items based on similarity and rated them by importance and feasibility. Using concept mapping analyses, items were grouped into meaningful domains to develop an initial tool. We then recruited pilot sites and early adopters, for a total of 286 practicing clinicians, to pilot and evaluate the tool. Individuals were recruited from clinical settings across pediatric and adult medical and surgical subspecialties. The data were analyzed using confirmatory factor analysis (CFA) to test hypothesized subscale structure in the instrument. We used root mean square error of approximation (RMSEA) and the standardized root mean square residual (SRMR) to assess fit and thus the ability of CSAT to measure the identified domains. Results The concept mapping produced sorted statements that were edited into items that could be responded to, resulting in the creation of a tool with seven determinant domains and 47 items. The pilot and CFA testing resulted in a final CSAT instrument made up 35 items, five per domain. CFA results demonstrated very good fit of the seven domain structure of the CSAT (RMSEA = 0.049; SRMR = 0.049). Usability testing indicated the CSAT is brief, easy to use, easy to learn, and does not require extensive training. Additionally, the measure scored highly (18/20) on the Psychometric and Pragmatic Evidence Rating Scale (PAPERS). The seven final CSAT domains were engaged staff and leadership, engaged stakeholders, organizational readiness, workflow integration, implementation and training, monitoring and evaluation, and outcomes and effectiveness. Conclusions The CSAT is a new reliable assessment tool which allows for greater practical and scientific understanding of contextual factors that enable sustainable clinical practices over time.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Consequently, there have been recent calls for increased attention to sustainability research, theory, and methods [ 4 , 11 ]. In response to this, the Sustainment Measurement System Scale (SMSS) was developed to understand both determinants and outcomes of sustainment for mental health and substance abuse programs [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Sustainability Assessment Tool: measuring organizational capacity to promote sustainability in healthcare

Malone

Prewitt

Hackett

et al. 2021

Implement Sci Commun

View full text Add to dashboard Cite

show abstract

“…The second limitation is that the existing clinical sustainability measures have limited reliability and validity data [ 12 , 13 ]. Implementation practitioners should consider using new sustainability tools as they are validated; however the varied contexts of sustainability between communities and clinical settings may require measurement adaptations [ 23 ]. Despite their limitations, our clinical and research team felt that the chosen assessment tools provided valuable information for program sustainment.…”

Section: Discussionmentioning

confidence: 99%

Sustainment of proactive physical therapy for individuals with early-stage Parkinson’s disease: a quality improvement study over 4 years

MacDonald

Doyle

Moore

et al. 2021

Implement Sci Commun

View full text Add to dashboard Cite

Background Implementation science frameworks aided the development of a new, evidence-based clinical physical therapy program. The purpose of this report is to describe the process of sustaining a clinical program in practice for over 4 years. We present a framework for integrating tools for sustainability with the Knowledge-to-Action model in the context of a proactive physical therapy (PAPT) program for individuals with early-stage Parkinson’s disease. Methods Sustainability of implementation strategies was addressed using the Dynamic Sustainability Framework and sustainability assessment tools. Repeated retrospective medical record reviews and phone interviews were used to evaluate the reach and adoption of the PAPT over 4 years. Characteristics of those who engaged with PAPT, implementation fidelity, and clinical effectiveness were assessed for year 1 and year 3. Sustainability was measured using RE-AIM, NHS Sustainability Model, and Clinical Sustainability Assessment Tool. Results Reach increased from 28 to 110 total patients per year and spread occurred from one to three sites. PAPT user age, sex, Hoehn and Yahr rating, time since diagnosis, and type of insurance were similar in year 1 and year 3 (p > 0.05). The program sustained its effect to help participants increase or maintain self-reported exercise (Y1, 95%; Y3, 100%). However, upon evaluation PAPT users in year 3 had longer time since symptom onset and worse UPDRS motor scores compared to the PAPT users in year 1 (p < 0.05). All sites sustained the core intervention components, with sustainability scores of 71/100 (± 9.9) on the NHS Sustainability Model and 6.1/7 (± 0.9) on the Clinical Sustainability Assessment Tool. Conclusions Integrating multiple sustainability models and assessments supported continued effectiveness, spread, and sustainment of PAPT for 4 years. Effective planning, anticipating common healthcare changes, and addressing sustainability determinants early in program implementation were essential aspects of long-term success.

show abstract

“…However, many evidence-based programs and policies are not sustained after initial implementation, wasting large amounts of financial, organizational, and social capital ( 60 ). Fortunately, new work has started making the case for more systematic study of sustainability, including conceptual development ( 35 , 148 ), method development ( 94 , 100 , 128 ), and applications to various health disciplines, such as public health, mental health, and health care delivery systems ( 19 ). An important audience to consider when designing for sustainability is policy makers—those who make decisions at both local or organizational levels (small p policy) and national or international levels (big P policy) about how and by whom public health and health care should be delivered and financed ( 23 ).…”

Section: Historical Contextmentioning

confidence: 99%

Designing for Dissemination and Sustainability to Promote Equitable Impacts on Health

Kwan

Brownson

Glasgow

et al. 2022

Annu. Rev. Public Health

104

View full text Add to dashboard Cite

Designing for dissemination and sustainability (D4DS) refers to principles and methods for enhancing the fit between a health program, policy, or practice and the context in which it is intended to be adopted. In this article we first summarize the historical context of D4DS and justify the need to shift traditional health research and dissemination practices. We present a diverse literature according to a D4DS organizing schema and describe a variety of dissemination products, design processes and outcomes, and approaches to messaging, packaging, and distribution. D4DS design processes include stakeholder engagement, participatory codesign, and context and situation analysis, and leverage methods and frameworks from dissemination and implementation science, marketing and business, communications and visual arts, and systems science. Finally, we present eight recommendations to adopt a D4DS paradigm, reflecting shifts in ways of thinking, skills and approaches, and infrastructure and systems for training and evaluation. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

show abstract

Measurement of sustainment of prevention programs and initiatives: the sustainment measurement system scale

Cited by 29 publications

References 48 publications

The Clinical Sustainability Assessment Tool: measuring organizational capacity to promote sustainability in healthcare

The Clinical Sustainability Assessment Tool: measuring organizational capacity to promote sustainability in healthcare

Sustainment of proactive physical therapy for individuals with early-stage Parkinson’s disease: a quality improvement study over 4 years

Designing for Dissemination and Sustainability to Promote Equitable Impacts on Health

Contact Info

Product

Resources

About