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Rogova A, Leal IM, Britton M, Chen TA, Lowenstein LM, Kyburz B, Casey K, Skeene K, Williams T, Reitzel LR. Implementing a tobacco-free workplace program at a substance use treatment center: a case study. BMC Health Serv Res 2024; 24:201. [PMID: 38355470 PMCID: PMC10865640 DOI: 10.1186/s12913-024-10629-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND People with substance use disorders smoke cigarettes at much higher rates than the general population in the United States and are disproportionately affected by tobacco-related diseases. Many substance use treatment centers do not provide evidence-based tobacco cessation treatment or maintain comprehensive tobacco-free workplace policies. The goal of the current work is to identify barriers and facilitators to a successful and sustainable implementation of a tobacco-free workplace program, which includes a comprehensive tobacco-free policy and evidence-based cessation treatment services, in a substance use treatment center. METHODS This study is based on an ethnographic approach and uses a qualitative case study design. Data were collected via interviews with staff (n = 6) and clients (n = 16) at the substance use treatment center and site visits (n = 8). Data were analyzed using thematic analysis guided by the extended Normalization Process Theory designed to inform the implementation of innovations in healthcare practice. RESULTS Staff at the substance use treatment center supported the implementation of the program and shared a good understanding of the purpose of the intervention and its potential benefits. However, the study identified significant challenges faced by the center during implementation, including widespread tobacco use among clients, contributing to attitudes among staff that tobacco cessation was a low-priority problem due to a perceived lack of interest in quitting and inability to quit among their clients. We identified several factors that contributed to changing this attitude, including provision of tobacco training to staff, active leadership support, low number of staff members who smoked, and access to material resources, including nicotine replacement products. The implementation and active enforcement of a comprehensive tobacco-free workplace program contributed to a gradual change in attitudes and improved the provision of evidence-based tobacco cessation care at the substance use treatment center. CONCLUSIONS Substance use treatment centers can integrate tobacco cessation practices in their daily operations, despite multiple challenges they face due to the complex behavioral health and socioeconomic needs of their clients. With proper support, substance use treatment centers can provide much needed tobacco cessation care to their clients who are disproportionately affected by tobacco-related health conditions and systemic health inequities.
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Affiliation(s)
- Anastasia Rogova
- The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 77230-1402, Houston, TX, Unit 1444, P.O. Box 301402, United States of America.
- University of Houston, 3657 Cullen Blvd, Stephen Power Farish Hall, 77204, Houston, TX, United States of America.
| | - Isabel Martinez Leal
- The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 77230-1402, Houston, TX, Unit 1444, P.O. Box 301402, United States of America
- University of Houston, 3657 Cullen Blvd, Stephen Power Farish Hall, 77204, Houston, TX, United States of America
| | - Maggie Britton
- The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 77230-1402, Houston, TX, Unit 1444, P.O. Box 301402, United States of America
- University of Houston, 3657 Cullen Blvd, Stephen Power Farish Hall, 77204, Houston, TX, United States of America
| | - Tzuan A Chen
- University of Houston, 3657 Cullen Blvd, Stephen Power Farish Hall, 77204, Houston, TX, United States of America
| | - Lisa M Lowenstein
- The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 77230-1402, Houston, TX, Unit 1444, P.O. Box 301402, United States of America
| | - Bryce Kyburz
- Integral Care, 1430 Collier St, 78704, Austin, TX, United States of America
| | - Kathleen Casey
- Integral Care, 1430 Collier St, 78704, Austin, TX, United States of America
| | - Kim Skeene
- Integral Care, 1430 Collier St, 78704, Austin, TX, United States of America
| | - Teresa Williams
- Integral Care, 1430 Collier St, 78704, Austin, TX, United States of America
| | - Lorraine R Reitzel
- The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 77230-1402, Houston, TX, Unit 1444, P.O. Box 301402, United States of America
- University of Houston, 3657 Cullen Blvd, Stephen Power Farish Hall, 77204, Houston, TX, United States of America
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Bisson M, Aubrey‐Bassler K, Chouinard M, Doucet S, Ramsden VR, Dumont‐Samson O, Howse D, Lambert M, Schwarz C, Luke A, Rabbitskin N, Gaudreau A, Porter J, Rubenstein D, Taylor J, Warren M, Hudon C. Patient engagement in health implementation research: A logic model. Health Expect 2023; 26:1854-1862. [PMID: 37309078 PMCID: PMC10485341 DOI: 10.1111/hex.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/31/2023] [Accepted: 05/14/2023] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Growing evidence supports patient engagement (PE) in health implementation research to improve the quality, relevance and uptake of research. However, more guidance is needed to plan and operationalize PE before and throughout the research process. The aim of the study was to develop a logic model illustrating the causal links between context, resources, activities, outcomes and impact of PE in an implementation research programme. METHODS The Patient Engagement in Health Implementation Research Logic Model (hereafter the Logic Model) was developed using a descriptive qualitative design with a participatory approach, in the context of the PriCARE programme. This programme aims to implement and evaluate case management for individuals who frequently use healthcare services in primary care clinics across five Canadian provinces. Participant observation of team meetings was performed by all team members involved in the programme and in-depth interviews were conducted by two external research assistants with team members (n = 22). A deductive thematic analysis using components of logic models as coding categories was conducted. Data were pooled in the first version of the Logic Model, which was refined in research team meetings with patient partners. The final version was validated by all team members. RESULTS The Logic Model highlights the importance of integrating PE into the project before its commencement, with appropriate support in terms of funding and time allocation. The governance structure and leadership of both principal investigators and patient partners have significant effects on PE activities and outcomes. As an empirical and standardized illustration that facilitates a shared understanding, the Logic Model provides guidance for maximizing the impact of patient partnership in various contexts for research, patients, providers and health care. CONCLUSION The Logic Model will help academic researchers, decision makers and patient partners plan, operationalize, and assess PE in implementation research for optimal outcomes. PATIENT OR PUBLIC CONTRIBUTION Patient partners from the PriCARE research programme contributed to developing the research objectives and designing, developing and validating data collection tools, producing data, developing and validating the Logic Model and reviewing the manuscript.
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Affiliation(s)
- Mathieu Bisson
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
| | - Kris Aubrey‐Bassler
- Primary Healthcare Research Unit, Faculty of MedicineMemorial UniversitySt. John'sNewfoundland and LabradorCanada
| | | | - Shelley Doucet
- Department of Nursing and Health SciencesUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Vivian R. Ramsden
- Department of Academic Family MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Olivier Dumont‐Samson
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
| | - Dana Howse
- Primary Healthcare Research Unit, Faculty of MedicineMemorial UniversitySt. John'sNewfoundland and LabradorCanada
| | - Mireille Lambert
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
| | - Charlotte Schwarz
- Department of Nursing and Health SciencesUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Alison Luke
- Department of Nursing and Health SciencesUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Norma Rabbitskin
- Department of Academic Family MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | | | | | | | | | | | - Catherine Hudon
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
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Villalobos A, Blachman-Demner D, Percy-Laurry A, Belis D, Bhattacharya M. Community and partner engagement in dissemination and implementation research at the National Institutes of Health: an analysis of recently funded studies and opportunities to advance the field. Implement Sci Commun 2023; 4:77. [PMID: 37438834 DOI: 10.1186/s43058-023-00462-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND As the focus has grown in recent years on both engaged research and dissemination and implementation (D&I) research, so too has federal funding to support these areas. The purpose of this analysis is to provide an overall perspective about the range of practices and approaches being used to engage partners in D&I research, with special attention to disparities-relevant research, and to identify gaps and opportunities in research funded by the US National Institutes of Health (NIH) in this space. METHODS This analysis examined a portfolio of active D&I research grants funded in fiscal years 2020 and 2021 across the NIH. Grant applications were deductively coded and summary statistics were calculated. Cross-tabulations were used to identify trends by engagement and disparities foci. RESULTS There were 103 grants included in the portfolio, of which 87% contained some form of community or partner engagement, and 50% of engaged grants were relevant to health disparities. Engagement was planned across the research continuum with each study engaging on average 2.5 different partner types. Consultation was the most common level of engagement (56%) while partnership was the least common (3%). On average, each study used 2.2 engagement strategies. Only 16% of grants indicated formally measuring engagement. Compared to non-disparities studies, disparities-relevant studies were about twice as likely to engage partners at the higher levels of partnership or collaboration (19% vs. 11%) and were also more likely to be conducted in community settings (26% vs. 5%). CONCLUSIONS Based on this portfolio analysis, D&I research appears to regularly integrate engagement approaches and strategies, though opportunities to deepen engagement and diversify who is engaged remain. This manuscript outlines several gaps in the portfolio and describes opportunities for increasing engagement to improve the quality of D&I research and application to advancing health equity. In addition, opportunities for leveraging the consistent and systematic application of engagement approaches and strategies to advance the science of engagement are discussed.
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Affiliation(s)
- Aubrey Villalobos
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD, 20892, USA.
| | - Dara Blachman-Demner
- Office of Behavioral and Social Sciences Research, Office of the Director, National Institutes of Health, 31 Center Dr, Bethesda, MD, 20892, USA
| | - Antoinette Percy-Laurry
- Office of Science Policy, Planning, Evaluation and Reporting, National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd, Bethesda, MD, 20817, USA
| | - Deshiree Belis
- Office of Behavioral and Social Sciences Research, Office of the Director, National Institutes of Health, 31 Center Dr, Bethesda, MD, 20892, USA
| | - Manami Bhattacharya
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD, 20892, USA
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Hudon C, Bisson M, Chouinard MC, Delahunty-Pike A, Lambert M, Howse D, Schwarz C, Dumont-Samson O, Aubrey-Bassler K, Burge F, Doucet S, Ramsden VR, Luke A, Macdonald M, Gaudreau A, Porter J, Rubenstein D, Scott C, Warren M, Wilhelm L. Implementation analysis of a case management intervention for people with complex care needs in primary care: a multiple case study across Canada. BMC Health Serv Res 2023; 23:377. [PMID: 37076851 PMCID: PMC10116737 DOI: 10.1186/s12913-023-09379-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 04/08/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Case management is one of the most frequently performed interventions to mitigate the negative effects of high healthcare use on patients, primary care providers and the healthcare system. Reviews have addressed factors influencing case management interventions (CMI) implementation and reported common themes related to the case manager role and activities, collaboration with other primary care providers, CMI training and relationships with the patients. However, the heterogeneity of the settings in which CMI have been implemented may impair the transferability of the findings. Moreover, the underlying factors influencing the first steps of CMI implementation need to be further assessed. This study aimed to evaluate facilitators and barriers of the first implementation steps of a CMI by primary care nurses for people with complex care needs who frequently use healthcare services. METHODS A qualitative multiple case study was conducted including six primary care clinics across four provinces in Canada. In-depth interviews and focus groups with nurse case managers, health services managers, and other primary care providers were conducted. Field notes also formed part of the data. A mixed thematic analysis, deductive and inductive, was carried out. RESULTS Leadership of the primary care providers and managers facilitated the first steps of the of CMI implementation, as did the experience and skills of the nurse case managers and capacity development within the teams. The time required to establish CMI was a barrier at the beginning of the CMI implementation. Most nurse case managers expressed apprehension about developing an "individualized services plan" with multiple health professionals and the patient. Clinic team meetings and a nurse case managers community of practice created opportunities to address primary care providers' concerns. Participants generally perceived the CMI as a comprehensive, adaptable, and organized approach to care, providing more resources and support for patients and better coordination in primary care. CONCLUSION Results of this study will be useful for decision makers, care providers, patients and researchers who are considering the implementation of CMI in primary care. Providing knowledge about first steps of CMI implementation will also help inform policies and best practices.
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Affiliation(s)
- Catherine Hudon
- Department of Family Medicine and Emergency Medicine, University of Sherbrooke, Pavillon Z7-Room 3007, 3001, 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada.
- Centre Hospitalier Universitaire de Sherbrooke Research Centre, Sherbrooke, QC, Canada.
| | - Mathieu Bisson
- Department of Family Medicine and Emergency Medicine, University of Sherbrooke, Pavillon Z7-Room 3007, 3001, 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | | | | | - Mireille Lambert
- Department of Family Medicine and Emergency Medicine, University of Sherbrooke, Pavillon Z7-Room 3007, 3001, 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Dana Howse
- Primary Healthcare Research Unit, Memorial University, St-John's, NL, Canada
| | - Charlotte Schwarz
- Department of Nursing and Health Sciences, University of New Brunswick, Fredericton, NB, Canada
| | - Olivier Dumont-Samson
- Department of Family Medicine and Emergency Medicine, University of Sherbrooke, Pavillon Z7-Room 3007, 3001, 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Kris Aubrey-Bassler
- Primary Healthcare Research Unit, Memorial University, St-John's, NL, Canada
| | - Fred Burge
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Shelley Doucet
- Department of Nursing and Health Sciences, University of New Brunswick, Fredericton, NB, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Alison Luke
- Department of Nursing and Health Sciences, University of New Brunswick, Fredericton, NB, Canada
| | - Marilyn Macdonald
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | | | - Judy Porter
- Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Cathy Scott
- Canadian Cancer Society, Toronto, ON, Canada
| | - Mike Warren
- Patient Advisory Council, Newfoundland and Labrador SPOR SUPPORT Unit, St. John's, NL, Canada
| | - Linda Wilhelm
- Canadian Arthritis Patient Alliance, Ottawa, ON, Canada
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Gorla F, Borojevic A, Gibertoni C, Landi L, Storchi M, Fontana L, Regmi J, Burmen B, Silenzi A. The Hospital of Tomorrow Case Study: Multidisciplinarity, Inclusiveness and Holistic Approaches to Foster Innovation in Complex Organizations. Int J Health Policy Manag 2023; 12:7330. [PMID: 37579430 PMCID: PMC10125057 DOI: 10.34172/ijhpm.2023.7330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 01/28/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND This case study describes and analyses an action research initiative undertaken by management, staff and WHO at the St. Orsola-Malpighi Polyclinic in Bologna, Italy. The initiative utilised staff engagement approaches developed during the COVID-19 pandemic to rethink and reshape future development plans. The initiative provides a 'how-to' case study for complex health facilities on ways to create similar multisectoral, inclusive and holistic processes in planning structural, functional and organizational solutions for their 'hospitals of tomorrow'. METHODS The case study utilised an action research approach coordinated by a team of WHO facilitators in close collaboration with the Board of Hospital Directors. Heterogeneous and multidisciplinary working groups were created, with members from different levels of the hospital staff. In the context of facilitated group meetings held weekly over a one-year period, participants were asked to review topics of interest to future plans of the hospital and make recommendations on effective/innovative ways of addressing these in the short and long term. Working groups focused on different challenges. RESULTS The initiative was successful in creating and sustaining broad staff engagement in the future planning processes. 80% groups maintained high staff participation throughout the entire project year. Participating staff reported enhanced communication and cooperation between departments represented in different groups. 87% of the proposed plans suggested by the working groups were approved by the Board for implementation. CONCLUSION Key factors contributing to the high approval rate of plans, strong engagement record of staff and enhanced cooperation between involved departments; included: multisectoral/cross hierarchal staff involvement, group attention to defining time-bound contextual goals, flexible implementation monitoring approaches, personnel skills and profiles of participants, direct and open communication at all levels and times, member commitment and clear exit strategy. The case study is presented as a model to stimulate similar actions in other complex health care facilities.
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Affiliation(s)
- Francesca Gorla
- World Health Organization, Headquarters, Geneva, Switzerland
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy
| | - Anja Borojevic
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
- James Lind Institute, Geneva, Switzerland
| | - Chiara Gibertoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy
| | - Lorena Landi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy
| | - Marco Storchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy
| | - Luca Fontana
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Jetri Regmi
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Barbara Burmen
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Anna Silenzi
- World Health Organization, Headquarters, Geneva, Switzerland
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Kirkpatrick L, Goldman P, Bell LA, Tyler CP, Harrison E, Russell M, Syed T, Szoko N, Kazmerski TM. Structured Engagement of Community Partners to Revise a Pregnancy Options Counseling Curriculum for Pediatric Residents. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231190476. [PMID: 37528948 PMCID: PMC10388627 DOI: 10.1177/23821205231190476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/05/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE The engagement of community partners, including patients, is increasingly recognized as important in developing medical education curricula. Structured methodology for partner engagement in curriculum development is lacking in the existing literature. This article describes a structured approach to engaging community partners to provide input on revising a curriculum for pediatric residents about pregnancy options counseling with adolescents. METHODS We used the five-step Method for Program Adaptation through Community Engagement: (1) development of a panel of community partners including patients and professionals, (2) and (3) partner evaluation of the existing curriculum and recommendations for revisions, (4) summarization of partner feedback, and (5) development of the revised curriculum. We surveyed partners about their perceived impact on the revision and satisfaction with the process. RESULTS Seventeen partners participated. Five experienced adolescent pregnancy, while the remaining 12 included healthcare and social service professionals. All partners provided multiple recommendations, generating 124 discrete recommendations. Twenty recommendations were suggested by multiple individuals. The authors reviewed all recommendations by category during consensus meetings and determined which recommendations would be incorporated into the revised curriculum to meet stated learning objectives. We implemented 14 of these 20 recommendations, including adding a values clarification exercise, information about mental health crisis resources, and more detail about adoption. We also incorporated 15 individual recommendations pertaining to curriculum clarity. Recommendations from professionals and patients were similar. Fourteen out of 17 participants completed the survey at the close of the project. All respondents understood their roles, were satisfied with their degree of engagement, and felt that their expectations for participation were met or exceeded. CONCLUSIONS This study describes a methodology for a formal process to engage community partners in curriculum development and revision processes. Such methodology can ensure that medical education curricula are optimally attuned to the needs of key community members and integrate the patient's voice.
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Affiliation(s)
- Laura Kirkpatrick
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Paula Goldman
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren Arnold Bell
- Department of Pediatrics, Riley Children's Hospital, 705 Riley Hospital Drive, Indianapolis, IN, USA
| | | | - Elizabeth Harrison
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Margaret Russell
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Tahniat Syed
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas Szoko
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Traci M Kazmerski
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Center for Innovative Research on Gender Health Equity, Pittsburgh, PA, USA
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Briand C, Roebuck M, Vallée C, Bergeron-Leclerc C, Krupa T, Durbin J, Aubry T, Goscha R, Latimer E. Implementation of strengths model case management in seven mental health agencies in Canada: Direct-service practitioners' implementation experience. J Eval Clin Pract 2022; 28:1127-1137. [PMID: 35560475 DOI: 10.1111/jep.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/07/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
RATIONALE Implementation of strengths model case management is increasing internationally. However, few studies have focused on its implementation process, and none have specifically addressed the implementation experience of direct-service practitioners. OBJECTIVE This paper presents factors that facilitate and impede the successful implementation of the strengths model, with a specific focus on practitioners who deliver the intervention directly to service recipients. METHOD To address this objective, a qualitative study of seven mental health agencies that implemented the model was conducted, involving a combination of participant observations and qualitative semistructured interviews with case managers, team supervisors, and senior managers. Qualitative data were analyzed using open coding followed by axial coding. Finally, the findings were aligned with an adapted Consolidated Framework for Implementation Research. RESULTS Implementation of the strengths model involved a significant change in practice for case management practitioners. The results confirm that at the beginning of implementation, the strengths model was perceived as complex and not always adaptable to on-the-ground realities. With time, and with support from management, ongoing training and supervision sessions, and reflection and discussion, practitioners regained feelings of competence and resistance to the model diminished. The use of the model's structured team-based supervision tools was fundamental to supporting the implementation process by enabling an interactive and concrete training approach. CONCLUSIONS The more an approach leads to changes in daily practice and is perceived as complex, the more concrete support is needed during implementation. This article highlights the importance of attending to a practitioner's sense of personal effectiveness and competence in the adoption of new practices.
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Affiliation(s)
- Catherine Briand
- Research Center of Montreal Mental Health University Institut, Montreal, Québec, Canada.,Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Maryann Roebuck
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Catherine Vallée
- Department of Rehabilitation, Université Laval, Quebec City, Québec, Canada
| | | | - Terry Krupa
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Janet Durbin
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Tim Aubry
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Rick Goscha
- California Institut for Behavioural Health Solutions (CIBHS), Sacramento, California, USA
| | - Eric Latimer
- Research Center of Douglas Mental Health University Institut, Montreal, Québec, Canada.,Department of Psychiatry, McGill University, Montreal, Québec, Canada
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O'Neil D, King L, Enderle J, Leal M, Olivas E. Smoke-Free Policy Adoption in Horizon City and El Paso Community College: A Strategic Campaign Approach That Turns a "No" Into a "Yes". Health Promot Pract 2022; 24:170S-179S. [PMID: 36419249 DOI: 10.1177/15248399221131316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article is temporarily under embargo.
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Affiliation(s)
| | - Laura King
- American Heart Association, Dallas, TX, USA
| | | | | | - Eva Olivas
- American Heart Association, Dallas, TX, USA
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