Preaching to the Choir? Predictors of Engagement in a Community-Based Learning Collaborative

Jensen‐Doss, Amanda; Smith, Ashley M.; Walsh, Lucia M.; Ringle, Vanesa Mora; Casline, Elizabeth; Patel, Zabin S.; Shaw, Ashley M.; Maxwell, Colleen A.; Hanson, Rochelle F.; Webster, Ruthlyn

doi:10.1007/s10488-019-00985-4

Cited by 16 publications

(9 citation statements)

References 39 publications

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“…Kellogg Foundation offers a Logic Model Development Guide as a resource for non-profit organizations. 77 Be guided by the evidence on how to promote improvement and implementation, but do not be paralyzed by imperfections in the evidence. Professional perspectives about the effectiveness of learning collaboratives differ, which came to light during expert interviews.…”

Section: For Any Quality Improvement or Implementation Initiativementioning

confidence: 99%

Learning Collaboratives: a Strategy for Quality Improvement and Implementation in Behavioral Health

Gotham

Paris

Hoge

2022

J Behav Health Serv Res

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Learning collaboratives are increasingly used in behavioral health. They generally involve bringing together teams from different organizations and using experts to educate and coach the teams in quality improvement, implementing evidence-based practices, and measuring the effects. Although learning collaboratives have demonstrated some effectiveness in general health care, the evidence is less clear in behavioral health and more rigorous studies are needed. Learning collaboratives may contain a range of elements, and which elements are included in any one learning collaborative varies widely; the unique contribution of each element has not been established. This commentary seeks to clarify the concept of a learning collaborative, highlight its common elements, review evidence of its effectiveness, identify its application in behavioral health, and highlight recommendations to guide technical assistance purveyors and behavioral health providers as they employ learning collaboratives to improve behavioral health access and quality.

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Section: For Any Quality Improvement or Implementation Initiativementioning

confidence: 99%

Learning Collaboratives: a Strategy for Quality Improvement and Implementation in Behavioral Health

Gotham

Paris

Hoge

2022

J Behav Health Serv Res

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“…Defined here as shared perceptions on the importance of evidence-based practice implementation within an organization, Ehrhart et al [ 11 ] suggest that implementation climate creates a fertile organizational context for putting an evidence-based intervention into practice in an organization. The concept has been applied to explore, for example, individual and organizational factors that influence the implementation of interventions for children with autism [ 12 ], to optimize clinician’s implementation of evidence-based practice in behavioral health organizations [ 13 ], and to assess predictors of engagement in a community-based learning collaborative [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the integration of evidence-based task-strengthening strategies for hypertension control within HIV clinics in Nigeria

Iwelunmor

Ezechi

Obiezu-Umeh

et al. 2022

Implement Sci Commun

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Background Evidence-based task-strengthening strategies for hypertension (HTN) control (TASSH) are not readily available for patients living with HIV in sub-Saharan Africa where the dual burden of HTN and HIV remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of practice facilitation versus a self-directed control (i.e., receipt of TASSH with no practice facilitation) in reducing blood pressure and increasing the adoption of task-strengthening strategies for HTN control within HIV clinics in Nigeria. Prior to implementing the trial, we conducted formative research to identify factors that may influence the integration of TASSH within HIV clinics in Nigeria. Methods This mixed-methods study was conducted with purposively selected healthcare providers at 29 HIV clinics, followed by a 1-day stakeholder meeting with 19 representatives of HIV clinics. We collected quantitative practice assessment data using two instruments: (a) an adapted Service Availability and Readiness Assessment (SARA) tool to assess the capacity of the clinic to manage NCDs and (b) Implementation Climate Scale to assess the degree to which there is a strategic organizational climate supportive of the evidence-based practice implementation. The quantitative data were analyzed using descriptive statistics and measures of scale reliability. We also used the Consolidated Framework for Implementation Research (CFIR), to thematically analyze qualitative data generated and relevant to the aims of this study. Results Across the 29 clinics surveyed, the focus on TASSH (mean=1.77 (SD=0.59)) and educational support (mean=1.32 (SD=0.68)) subscales demonstrated the highest mean score, with good–excellent internal consistency reliability (Cronbach’s alphas ranging from 0.84 to 0.96). Within the five CFIR domains explored, the major facilitators of the intervention included relative advantage of TASSH compared to current practice, compatibility with clinic organizational structures, support of patients’ needs, and intervention alignment with national guidelines. Barriers included the perceived complexity of TASSH, weak referral network and patient tracking mechanism within the clinics, and limited resources and diagnostic equipment for HTN. Conclusion Optimizing healthcare workers’ implementation of evidence-based TASSH within HIV clinics requires attention to both the implementation climate and contextual factors likely to influence adoption and long-term sustainability. These findings have implications for the development of effective practice facilitation strategies to further improve the delivery and integration of TASSH within HIV clinics in Nigeria. Trial registration ClinicalTrials.gov, NCT04704336

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“…De ned here as shared perceptions on the importance of evidence-based practice implementation within an organization, Erhart et al, (2014) suggest that implementation climate creates a fertile organizational context for putting an evidence-based intervention into practice in an organization [10]. The concept has been applied to explore, for example, individual and organizational factors that in uence the implementation of interventions for children with autism [11], to optimize clinician's implementation of evidence-based practice in behavioral health organizations [12], as well as to assess predictors of engagement in a community-based learning collaborative [13].…”

Section: Introductionmentioning

confidence: 99%

Mapping implementation climate for integrating evidence-based task-strengthening strategies for hypertension control within HIV clinics in Nigeria

Iwelunmor

Ezechi

Obiezu-Umeh

et al. 2021

Preprint

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Background: Evidence-based task-strengthening strategies for hypertension (HTN) control (TASSH) are not readily available for patients living with HIV in sub-Saharan Africa where the dual burden of HTN and HIV remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of practice facilitation versus a self-directed control (i.e., receipt of TASSH with no practice facilitation) in reducing blood pressure and increasing the adoption of task-strengthening strategies for HTN control within HIV clinics in Nigeria. Prior to implementing the trial, we conducted formative research to identify factors that may influence the integration of TASSH within HIV clinics in Nigeria.Methods: This study was conducted with purposively selected healthcare providers at 29 HIV clinics, followed by a one-day stakeholder meeting with 19 representatives of HIV clinics. We collected quantitative practice assessment data using two instruments: a) an adapted Service Availability and Readiness Assessment (SARA) tool to assess the capacity of the clinic to manage NCDs and b) Implementation Climate Scale to assess the degree to which there is a strategic organizational climate supportive of the evidence-based practice implementation. The quantitative data were analyzed using descriptive statistics and measures of scale reliability. We also used the Consolidated Framework for Implementation Research (CFIR), to thematically analyze qualitative data generated and relevant to the aims of this study.Results:Across the 29 clinics surveyed, the focus on TASSH (mean=1.77 (SD=0.59)) and educational support (mean=1.32 (SD=0.68)) subscales demonstrated the highest mean score, with good–excellent internal consistency reliability (Cronbach's alphas ranging from 0.84 to 0.96). Within the five CFIR domains explored, the major facilitators of the intervention included relative advantage of TASSH compared to current practice, compatibility with clinic organizational structures, support of patients' needs, and intervention alignment with national guidelines. Barriers included perceived complexity of TASSH, weak referral network and patient tracking mechanism within the clinics, and limited resources and diagnostic equipment for HTN.Conclusion:Optimizing healthcare workers' implementation of evidence-based TASSH within HIV clinics requires attention to both the implementation climate and contextual factors likely to influence adoption and long-term sustainability. These findings have implications for the development of effective practice facilitation strategies to further improve the delivery and integration of TASSH within HIV clinics in Nigeria.

show abstract

Preaching to the Choir? Predictors of Engagement in a Community-Based Learning Collaborative

Cited by 16 publications

References 39 publications

Learning Collaboratives: a Strategy for Quality Improvement and Implementation in Behavioral Health

Learning Collaboratives: a Strategy for Quality Improvement and Implementation in Behavioral Health

Factors influencing the integration of evidence-based task-strengthening strategies for hypertension control within HIV clinics in Nigeria

Mapping implementation climate for integrating evidence-based task-strengthening strategies for hypertension control within HIV clinics in Nigeria

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