The Rapid Implementation Feedback (RIF) report: real-time synthesis of qualitative data for proactive implementation planning and tailoring.
Evidence-based practice
Implementation planning
Implementation strategies
Rapid qualitative methods
Tailoring
Journal
Implementation science communications
ISSN: 2662-2211
Titre abrégé: Implement Sci Commun
Pays: England
ID NLM: 101764360
Informations de publication
Date de publication:
21 Jun 2024
21 Jun 2024
Historique:
received:
14
12
2023
accepted:
09
06
2024
medline:
22
6
2024
pubmed:
22
6
2024
entrez:
21
6
2024
Statut:
epublish
Résumé
Qualitative methods are a critical tool for enhancing implementation planning and tailoring, yet rapid turn-around of qualitative insights can be challenging in large implementation trials. The Department of Veterans Affairs-funded EMPOWER 2.0 Quality Enhancement Research Initiative (QUERI) is conducting a hybrid type 3 effectiveness-implementation trial comparing the impact of Replicating Effective Programs (REP) and Evidence-Based Quality Improvement (EBQI) as strategies for implementing three evidence-based practices (EBPs) for women Veterans. We describe the development of the Rapid Implementation Feedback (RIF) report, a pragmatic, team-based approach for the rapid synthesis of qualitative data to aid implementation planning and tailoring, as well as findings from a process evaluation of adopting the RIF report within the EMPOWER 2.0 QUERI. Trained qualitative staff conducted 125 semi-structured pre-implementation interviews with frontline staff, providers, and leadership across 16 VA sites between October 2021 and October 2022. High-priority topic domains informed by the updated Consolidated Framework for Implementation Research were selected in dialogue between EMPOWER 2.0 implementation and evaluation teams, and relevant key points were summarized for each interview to produce a structured RIF report, with emergent findings about each site highlighted in weekly written and verbal communications. Process evaluation was conducted to assess EMPOWER 2.0 team experiences with the RIF report across pre-implementation data collection and synthesis and implementation planning and tailoring. Weekly RIF updates supported continuous EMPOWER 2.0 team communication around key findings, particularly questions and concerns raised by participating sites related to the three EBPs. Introducing the RIF report into team processes enhanced: team communication; quality and rigor of qualitative data; sensemaking around emergent challenges; understanding of site readiness; and tailoring of REP and EBQI implementation strategies. RIF report findings have facilitated rapid tailoring of implementation planning and rollout, supporting increased responsiveness to sites' needs and concerns. The RIF report provides a structured strategy for distillation of time-sensitive findings, continuous team communication amid a complex multi-site implementation effort, and effective tailoring of implementation rollout in real-time. Use of the RIF report may also support trust-building by enhancing responsiveness to sites during pre- and early implementation. Enhancing Mental and Physical Health of Women Veterans (NCT05050266); https://clinicaltrials.gov/study/NCT05050266?term=EMPOWER%202.0&rank=1 Date of registration: 09/09/2021.
Sections du résumé
BACKGROUND
BACKGROUND
Qualitative methods are a critical tool for enhancing implementation planning and tailoring, yet rapid turn-around of qualitative insights can be challenging in large implementation trials. The Department of Veterans Affairs-funded EMPOWER 2.0 Quality Enhancement Research Initiative (QUERI) is conducting a hybrid type 3 effectiveness-implementation trial comparing the impact of Replicating Effective Programs (REP) and Evidence-Based Quality Improvement (EBQI) as strategies for implementing three evidence-based practices (EBPs) for women Veterans. We describe the development of the Rapid Implementation Feedback (RIF) report, a pragmatic, team-based approach for the rapid synthesis of qualitative data to aid implementation planning and tailoring, as well as findings from a process evaluation of adopting the RIF report within the EMPOWER 2.0 QUERI.
METHODS
METHODS
Trained qualitative staff conducted 125 semi-structured pre-implementation interviews with frontline staff, providers, and leadership across 16 VA sites between October 2021 and October 2022. High-priority topic domains informed by the updated Consolidated Framework for Implementation Research were selected in dialogue between EMPOWER 2.0 implementation and evaluation teams, and relevant key points were summarized for each interview to produce a structured RIF report, with emergent findings about each site highlighted in weekly written and verbal communications. Process evaluation was conducted to assess EMPOWER 2.0 team experiences with the RIF report across pre-implementation data collection and synthesis and implementation planning and tailoring.
RESULTS
RESULTS
Weekly RIF updates supported continuous EMPOWER 2.0 team communication around key findings, particularly questions and concerns raised by participating sites related to the three EBPs. Introducing the RIF report into team processes enhanced: team communication; quality and rigor of qualitative data; sensemaking around emergent challenges; understanding of site readiness; and tailoring of REP and EBQI implementation strategies. RIF report findings have facilitated rapid tailoring of implementation planning and rollout, supporting increased responsiveness to sites' needs and concerns.
CONCLUSIONS
CONCLUSIONS
The RIF report provides a structured strategy for distillation of time-sensitive findings, continuous team communication amid a complex multi-site implementation effort, and effective tailoring of implementation rollout in real-time. Use of the RIF report may also support trust-building by enhancing responsiveness to sites during pre- and early implementation.
TRIAL REGISTRATION
BACKGROUND
Enhancing Mental and Physical Health of Women Veterans (NCT05050266); https://clinicaltrials.gov/study/NCT05050266?term=EMPOWER%202.0&rank=1 Date of registration: 09/09/2021.
Identifiants
pubmed: 38907331
doi: 10.1186/s43058-024-00605-9
pii: 10.1186/s43058-024-00605-9
doi:
Banques de données
ClinicalTrials.gov
['NCT05050266']
Types de publication
Journal Article
Langues
eng
Pagination
69Subventions
Organisme : Quality Enhancement Research Initiative
ID : QUE 20-028
Organisme : Quality Enhancement Research Initiative
ID : QIS 22-234
Informations de copyright
© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
Références
Krause J, Van Lieshout J, Klomp R, Huntink E, Aakhus E, Flottorp S, et al. Identifying determinants of care for tailoring implementation in chronic diseases: an evaluation of different methods. Implementation Sci. 2014;9(1):102.
doi: 10.1186/s13012-014-0102-3
Treichler EBH, Mercado R, Oakes D, Perivoliotis D, Gallegos-Rodriguez Y, Sosa E, et al. Using a stakeholder-engaged, iterative, and systematic approach to adapting collaborative decision skills training for implementation in VA psychosocial rehabilitation and recovery centers. BMC Health Serv Res. 2022;22(1):1543.
pubmed: 36528579
pmcid: 9759039
doi: 10.1186/s12913-022-08833-2
Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implementation Science. 2013;8(1). Available from: http://implementationscience.biomedcentral.com/articles/ https://doi.org/10.1186/1748-5908-8-117 Cited 2017 Mar 14.
Hamilton AB, Finley EP. Qualitative methods in implementation research: An introduction. Psychiatry Res. 2019;280:112516.
pubmed: 31437661
pmcid: 7023962
doi: 10.1016/j.psychres.2019.112516
Cohen D, Crabtree BF, Damschroder LJ, Hamilton AB, Heurtin-Roberts S, Leeman J, et al. Qualitative Methods in Implementation Science. National Cancer Institute; 2018. Available from: https://cancercontrol.cancer.gov/sites/default/files/2020-09/nci-dccps-implementationscience-whitepaper.pdf
Cunningham-Erves J, Mayo-Gamble T, Vaughn Y, Hawk J, Helms M, Barajas C, et al. Engagement of community stakeholders to develop a framework to guide research dissemination to communities. Health Expect. 2020;23(4):958–68.
pubmed: 32452067
pmcid: 7495063
doi: 10.1111/hex.13076
Hamilton AB, Brunner J, Cain C, Chuang E, Luger TM, Canelo I, et al. Engaging multilevel stakeholders in an implementation trial of evidence-based quality improvement in VA women’s health primary care. Behav Med Pract Policy Res. 2017;7(3):478–85.
doi: 10.1007/s13142-017-0501-5
Hamilton. Qualitative methods in rapid turn-around health services research. 2013 Dec 11; VA HSR&D Cyberseminar Spotlight on Women’s Health. Available from: http://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/780-notes.pdf
St. George SM, Harkness AR, Rodriguez-Diaz CE, Weinstein ER, Pavia V, Hamilton AB. Applying Rapid Qualitative Analysis for Health Equity: Lessons Learned Using “EARS” With Latino Communities. Int J Qual Methods. 2023;22:160940692311649.
doi: 10.1177/16094069231164938
Finley EP, Huynh AK, Farmer MM, Bean-Mayberry B, Moin T, Oishi SM, et al. Periodic reflections: a method of guided discussions for documenting implementation phenomena. BMC Med Res Methodol. 2018;18(1):153.
pubmed: 30482159
pmcid: 6258449
doi: 10.1186/s12874-018-0610-y
Gertner AK, Franklin J, Roth I, Cruden GH, Haley AD, Finley EP, et al. A scoping review of the use of ethnographic approaches in implementation research and recommendations for reporting. Implementation Research and Practice. 2021;2:263348952199274.
doi: 10.1177/2633489521992743
Palinkas LA, Zatzick D. Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) in Pragmatic Clinical Trials of Mental Health Services Implementation: Methods and Applied Case Study. Adm Policy Ment Health. 2019;46(2):255–70.
pubmed: 30488143
pmcid: 7427407
doi: 10.1007/s10488-018-0909-3
Lanham HJ, McDaniel RR, Crabtree BF, Miller WL, Stange KC, Tallia AF, et al. How Improving Practice Relationships Among Clinicians and Nonclinicians Can Improve Quality in Primary Care. Jt Comm J Qual Patient Saf. 2009;35(9):457–66.
pubmed: 19769206
pmcid: 2928073
Miake-Lye IM, Delevan DM, Ganz DA, Mittman BS, Finley EP. Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments. BMC Health Serv Res. 2020;20(1):106.
pubmed: 32046708
pmcid: 7014613
doi: 10.1186/s12913-020-4926-z
Finley EP, Closser S, Sarker M, Hamilton AB. Editorial: The theory and pragmatics of power and relationships in implementation. Front Health Serv. 2023;23(3):1168559.
doi: 10.3389/frhs.2023.1168559
Bartley L, Metz A, Fleming WO. What implementation strategies are relational? Using Relational Theory to explore the ERIC implementation strategies. FrontHealth Serv. 2022;17(2):913585.
doi: 10.3389/frhs.2022.913585
Metz A, Jensen T, Farley A, Boaz A, Bartley L, Villodas M. Building trusting relationships to support implementation: A proposed theoretical model. FrontHealth Serv. 2022;23(2):894599.
doi: 10.3389/frhs.2022.894599
Ketley D. A new and unique resource to help you spread and scale innovation and improvement. NHS Horizons. 2023. Available from: https://horizonsnhs.com/a-new-and-unique-resource-to-help-you-spread-and-scale-innovation-and-improvement/ Cited 2023 Mar 27
Dyer KE, Moreau JL, Finley E, Bean-Mayberry B, Farmer MM, Bernet D, et al. Tailoring an evidence-based lifestyle intervention to meet the needs of women Veterans with prediabetes. Women Health. 2020;60(7):748–62.
pubmed: 31959089
pmcid: 8435559
doi: 10.1080/03630242.2019.1710892
Goldstein KM, Melnyk SD, Zullig LL, Stechuchak KM, Oddone E, Bastian LA, et al. Heart Matters: Gender and Racial Differences Cardiovascular Disease Risk Factor Control Among Veterans. Women’s Health Issues. 2014;24(5):477–83.
pubmed: 25213741
doi: 10.1016/j.whi.2014.05.005
Vimalananda VG, Biggs ML, Rosenzweig JL, Carnethon MR, Meigs JB, Thacker EL, et al. The influence of sex on cardiovascular outcomes associated with diabetes among older black and white adults. J Diabetes Complications. 2014;28(3):316–22.
pubmed: 24461547
doi: 10.1016/j.jdiacomp.2013.12.004
Breland JY, Phibbs CS, Hoggatt KJ, Washington DL, Lee J, Haskell S, et al. The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans. J GEN INTERN MED. 2017;32(S1):11–7.
pubmed: 28271422
pmcid: 5359156
doi: 10.1007/s11606-016-3962-1
Sheahan KL, Goldstein KM, Than CT, Bean-Mayberry B, Chanfreau CC, Gerber MR, et al. Women Veterans’ Healthcare Needs, Utilization, and Preferences in Veterans Affairs Primary Care Settings. J GEN INTERN MED. 2022;37(S3):791–8.
pubmed: 36042076
pmcid: 9481772
doi: 10.1007/s11606-022-07585-3
Hamilton AB, Finley EP, Bean-Mayberry B, Lang A, Haskell SG, Moin T, et al. Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) 2.0 QUERI: study protocol for a cluster-randomized hybrid type 3 effectiveness-implementation trial. Implement Sci Commun. 2023Mar 8;4(1):23.
pubmed: 36890587
pmcid: 9994412
doi: 10.1186/s43058-022-00389-w
Moin T, Damschroder LJ, AuYoung M, Maciejewski ML, Havens K, Ertl K, et al. Results From a Trial of an Online Diabetes Prevention Program Intervention. Am J Prev Med. 2018;55(5):583–91.
pubmed: 30262149
pmcid: 6699502
doi: 10.1016/j.amepre.2018.06.028
Damschroder LJ, Reardon CM, Sperber N, Robinson CH, Fickel JJ, Oddone EZ. Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation. Behav Med Pract Policy Res. 2017;7(2):233–41.
doi: 10.1007/s13142-016-0424-6
Zlotnick C, Tzilos G, Miller I, Seifer R, Stout R. Randomized controlled trial to prevent postpartum depression in mothers on public assistance. J Affect Disord. 2016;189:263–8.
pubmed: 26454186
doi: 10.1016/j.jad.2015.09.059
Kilbourne AM, Neumann MS, Pincus HA, Bauer MS, Stall R. Implementing evidence-based interventions in health care: application of the replicating effective programs framework. Implementation Science. 2007;2(1). Available from: http://implementationscience.biomedcentral.com/articles/ https://doi.org/10.1186/1748-5908-2-42 Cited 2017 May 11
Rubenstein LV, Stockdale SE, Sapir N, Altman L, Dresselhaus T, Salem-Schatz S, et al. A Patient-Centered Primary Care Practice Approach Using Evidence-Based Quality Improvement: Rationale, Methods, and Early Assessment of Implementation. J GEN INTERN MED. 2014;29(S2):589–97.
pmcid: 4070240
doi: 10.1007/s11606-013-2703-y
Hamilton AB, Farmer MM, Moin T, Finley EP, Lang AJ, Oishi SM, et al. Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER): a protocol for a program of research. Implementation Science. 2017;12(1). Available from: https://implementationscience.biomedcentral.com/articles/ https://doi.org/10.1186/s13012-017-0658-9 Cited 2018 Jan 5
Kligler B. Whole Health in the Veterans Health Administration. Glob Adv Health Med. 2022;11:2164957X2210772.
doi: 10.1177/2164957X221077214
Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Sci. 2022;17(1):75.
doi: 10.1186/s13012-022-01245-0
Yano EM, Darling JE, Hamilton AB, Canelo I, Chuang E, Meredith LS, et al. Cluster randomized trial of a multilevel evidence-based quality improvement approach to tailoring VA Patient Aligned Care Teams to the needs of women Veterans. Implementation Sci. 2015;11(1):101.
doi: 10.1186/s13012-016-0461-z
Nevedal AL, Reardon CM, Opra Widerquist MA, Jackson GL, Cutrona SL, White BS, et al. Rapid versus traditional qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). Implementation Sci. 2021;16(1):67.
doi: 10.1186/s13012-021-01111-5
Kowalski C, Nevedal AL, Finley, Erin P., Young J, Lewinski A, Midboe AM, et al. Raising expectations for rapid qualitative implementation efforts: guidelines to ensure rigor in rapid qualitative study design, conduct, and reporting. 16th Annual Conference on the Science of Dissemination and Implementation in Health; 2023 Dec 13; Washington, D.C.
Gale RC, Wu J, Erhardt T, Bounthavong M, Reardon CM, Damschroder LJ, et al. Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration. Implementation Sci. 2019;14(1):11.
doi: 10.1186/s13012-019-0853-y
Braun V, Clarke V. Thematic analysis. In: Cooper H, Camic PM, Long DL, Panter AT, Rindskopf D, Sher KJ, editors. APA handbook of research methods in psychology, Vol 2: Research designs: Quantitative, qualitative, neuropsychological, and biological. Washington: American Psychological Association. 2012;57–71. Available from: http://content.apa.org/books/13620-004 Cited 2023 Mar 28
Torrance H. Triangulation, Respondent Validation, and Democratic Participation in Mixed Methods Research. J Mixed Methods Res. 2012;6(2):111–23.
doi: 10.1177/1558689812437185
Birt L, Scott S, Cavers D, Campbell C, Walter F. Member Checking: A Tool to Enhance Trustworthiness or Merely a Nod to Validation? Qual Health Res. 2016;26(13):1802–11.
pubmed: 27340178
doi: 10.1177/1049732316654870
Stirman SW, Miller CJ, Toder K, Calloway A. Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implementation Science. 2013;8(1). Available from: http://implementationscience.biomedcentral.com/articles/ https://doi.org/10.1186/1748-5908-8-65 Cited 2017 Sep 5
Miller CJ, Barnett ML, Baumann AA, Gutner CA, Wiltsey-Stirman S. The FRAME-IS: a framework for documenting modifications to implementation strategies in healthcare. Implementation Sci. 2021;16(1):36.
doi: 10.1186/s13012-021-01105-3
Wiltsey Stirman S, Baumann AA, Miller CJ. The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions. Implementation Sci. 2019;14(1):58.
doi: 10.1186/s13012-019-0898-y
Powell BJ, Beidas RS, Lewis CC, Aarons GA, McMillen JC, Proctor EK, et al. Methods to Improve the Selection and Tailoring of Implementation Strategies. J Behav Health Serv Res. 2017;44(2):177–94.
pubmed: 26289563
pmcid: 4761530
doi: 10.1007/s11414-015-9475-6
Ware P, Ross HJ, Cafazzo JA, Laporte A, Gordon K, Seto E. User-Centered Adaptation of an Existing Heart Failure Telemonitoring Program to Ensure Sustainability and Scalability: Qualitative Study. JMIR Cardio. 2018;2(2):e11466.
pubmed: 31758774
pmcid: 6857927
doi: 10.2196/11466
Chen EK, Reid MC, Parker SJ, Pillemer K. Tailoring Evidence-Based Interventions for New Populations: A Method for Program Adaptation Through Community Engagement. Eval Health Prof. 2013;36(1):73–92.
pubmed: 22523308
doi: 10.1177/0163278712442536
Moore G, Campbell M, Copeland L, Craig P, Movsisyan A, Hoddinott P, et al. Adapting interventions to new contexts—the ADAPT guidance. BMJ. 2021;3:n1679.
doi: 10.1136/bmj.n1679
Waltz TJ, Powell BJ, Matthieu MM, Damschroder LJ, Chinman MJ, Smith JL, et al. Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study. Implementation Science. 2015;10(1). Available from: http://implementationscience.biomedcentral.com/articles/ https://doi.org/10.1186/s13012-015-0295-0 Cited 2017 Sep 5
Fernandez ME, Ruiter RAC, Markham CM, Kok G. Intervention Mapping: Theory- and Evidence-Based Health Promotion Program Planning: Perspective and Examples. Front Public Health. 2019;7:209.
pubmed: 31475126
pmcid: 6702459
doi: 10.3389/fpubh.2019.00209
Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, Matthieu MM, et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science. 2015;10(1). Available from: http://implementationscience.biomedcentral.com/articles/ https://doi.org/10.1186/s13012-015-0209-1 Cited 2017 Nov 2
Connelly B, Gilmartin H, Hale A, Kenney R, Morgon B, Sjoberg H. The Relational Facilitation Guidebook [Internet]. Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care; 2023 Feb. Available from: https://www.seattledenvercoin.research.va.gov/education/rc/docs/Relational_Facilitation_Guidebook.pdf Cited 2023 Mar 29
Bonawitz K, Wetmore M, Heisler M, Dalton VK, Damschroder LJ, Forman J, et al. Champions in context: which attributes matter for change efforts in healthcare? Implementation Sci. 2020;15(1):62.
doi: 10.1186/s13012-020-01024-9
Demes JAE, Nickerson N, Farand L, Montekio VB, Torres P, Dube JG, et al. What are the characteristics of the champion that influence the implementation of quality improvement programs? Eval Program Plann. 2020;80:101795.
pubmed: 32087525
doi: 10.1016/j.evalprogplan.2020.101795
Flanagan ME, Plue L, Miller KK, Schmid AA, Myers L, Graham G, et al. A qualitative study of clinical champions in context: Clinical champions across three levels of acute care. SAGE Open Medicine. 2018;6:205031211879242.
doi: 10.1177/2050312118792426
Wood K, Giannopoulos V, Louie E, Baillie A, Uribe G, Lee KS, et al. The role of clinical champions in facilitating the use of evidence-based practice in drug and alcohol and mental health settings: A systematic review. Implementation Research and Practice. 2020;1:263348952095907.
doi: 10.1177/2633489520959072
Morse JM, Barrett M, Mayan M, Olson K, Spiers J. Verification strategies for establishing reliability and validity in qualitative research. Int J Qual Methods. 2002;1(2):13–22.
doi: 10.1177/160940690200100202
Abraham TH, Finley EP, Drummond KL, Haro EK, Hamilton AB, Townsend JC, et al. A Method for Developing Trustworthiness and Preserving Richness of Qualitative Data During Team-Based Analysis of Large Data Sets. Am J Eval. 2021;42(1):139–56.
doi: 10.1177/1098214019893784