Abstract:
BACKGROUND:It is challenging to interpret the results of multifaceted interventions due to complex program theories that are difficult to measure in a quantifiable manner. The aims of this paper were, first, to develop a model for a comprehensive quantitative implementation evaluation and, second, to operationalize it in the process evaluation of the stepped-wedge cluster randomized controlled trial: "Prevention of low back pain and its consequences among nurses' aides in elderly care" to investigate if implementation differed across intervention components, steps, and settings (workplaces). METHODS:Operationalization of a quantifiable measure of implementation requires three steps: (1) development of a program logic and intervention protocol, (2) description of a complete and acceptable delivery of the intervention, and (3) description of what determines the receipt of the intervention. Program logic from a previously developed multifaceted stepped-wedge intervention was used. The optimal delivery of the intervention was defined as the deliverers' full understanding and following of the intervention protocol and that they performed their best and contributed to the participants' attention and motivation (fidelity). The optimal receipt of the intervention was defined as participants being fully present at all intervention activities (participation), being motivated and satisfied, and having a good social support (responsiveness). Measurements of the fidelity, participation, and responsiveness were obtained from logbooks and questionnaires. Fidelity was multiplied by participation to measure exposure of the intervention to the individual. The implementation was determined from optimal delivery and optimal receipt on a scale from 0 (no implementation) to 100 (full implementation) on individual and organizational level. RESULTS:Out of 753 sessions, 95% were delivered. The sessions were delivered with 91% success (fidelity) across the organization. Average participation, fidelity, exposure, and responsiveness were 50, 93, 48, and 89% across all participants. The implementation of the intervention was uniform across steps (p = 0.252) and workplaces (p = 0.125) but not for intervention components (p = 0.000). However, participation, fidelity, exposure, and responsiveness varied between workplaces. CONCLUSIONS:This study developed a quantifiable implementation evaluation measuring participation, fidelity, exposure, and responsiveness. The quantifiable implementation evaluation was suitable for comparing implementation across steps, components, and settings and can be applied in the analyses on the impact of implementation of complex interventions.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Ferm L,Rasmussen CDN,Jørgensen MBdoi
10.1186/s13012-018-0720-2subject
Has Abstractpub_date
2018-02-08 00:00:00pages
26issue
1issn
1748-5908pii
10.1186/s13012-018-0720-2journal_volume
13pub_type
杂志文章,随机对照试验abstract:BACKGROUND:National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0855-9
更新日期:2019-01-28 00:00:00
abstract:BACKGROUND:Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-101
更新日期:2011-09-03 00:00:00
abstract:BACKGROUND:Adverse drug events could often be prevented. One of their main causes is that patients rarely know how to detect them. Another cause is inadequate communication between patients and physicians. If patients were to be effectively trained in detecting and reporting adverse drug events, this should help to pre...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-8-69
更新日期:2013-06-19 00:00:00
abstract:BACKGROUND:Considerable racial and socio-economic disparities exist in breast cancer. In spite of the existence of numerous evidence-based interventions (EBIs) aimed at reducing breast cancer screening barriers among the underserved, there is a lack of uptake or sub-optimal uptake of EBIs in community and clinical sett...
journal_title:Implementation science : IS
pub_type: 临床试验,杂志文章
doi:10.1186/s13012-015-0334-x
更新日期:2015-10-14 00:00:00
abstract:OBJECTIVE:To quantify the extent to which clinicians use clinically-efficacious decision aids as intended during implementation in practice and how fidelity to usage instructions correlates with shared decision making (SDM) outcomes. METHODS:Participant-level meta-analysis including six practice-based randomized contr...
journal_title:Implementation science : IS
pub_type: 杂志文章,meta分析
doi:10.1186/1748-5908-9-26
更新日期:2014-02-22 00:00:00
abstract:BACKGROUND:Fecal incontinence has a high prevalence in the nursing home population which cannot be explained by co-morbidity or anatomic and physiological changes of aging alone. Our hypothesis is that fecal incontinence can be prevented, cured, or ameliorated by offering care staff knowledge of best practice. However,...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-015-0263-8
更新日期:2015-05-23 00:00:00
abstract:BACKGROUND:Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-19
更新日期:2008-04-09 00:00:00
abstract:BACKGROUND:Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta be...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-6-94
更新日期:2011-08-11 00:00:00
abstract:BACKGROUND:The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trai...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-105
更新日期:2013-09-05 00:00:00
abstract:BACKGROUND:An international randomized clinical trial (RCT) on pre-exposure prophylaxis (PrEP) as an human immunodeficiency virus (HIV)-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM) and male-to-female transgender women. Within the context of...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-116
更新日期:2012-11-26 00:00:00
abstract:BACKGROUND:Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions i...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0392-8
更新日期:2016-03-23 00:00:00
abstract:BACKGROUND:Adapting promising health care interventions to local settings is a critical component in the dissemination and implementation process. The Veterans Health Administration (VHA) rural transitions nurse program (TNP) is a nurse-led, Veteran-centered intervention designed to improve transitional care for rural ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0653-1
更新日期:2017-10-23 00:00:00
abstract:BACKGROUND:Evidence-based practice (EBP) is a complex process. To quantify it, one has to also consider individual and contextual factors using multiple measures. Modern measurement approaches are available to optimize the measurement of complex constructs. This study aimed to develop a robust measurement approach for ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0844-4
更新日期:2018-12-18 00:00:00
abstract:BACKGROUND:The continuing gap between available evidence and current practice in health care reinforces the need for more effective solutions, in particular related to organizational context. Considerable advances have been made within the U.S. Veterans Health Administration (VA) in systematically implementing evidence...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-30
更新日期:2008-05-29 00:00:00
abstract:BACKGROUND:Knowledge translation (KT) aims to close the research-practice gap in order to realize and maximize the benefits of research within the practice setting. Previous studies have investigated KT strategies in nursing and medicine; however, the present study is the first systematic review of the effectiveness of...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-7-70
更新日期:2012-07-25 00:00:00
abstract:BACKGROUND:Escalation of commitment is the tendency that (innovation) projects continue, even if it is clear that they will not be successful and/or become extremely costly. Escalation prevention potential (EPP), the capability of an organization to stop or steer implementation processes that do not meet their expectat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0435-1
更新日期:2016-05-20 00:00:00
abstract:BACKGROUND:The current syphilis epidemic among urban men who have sex with men (MSM) has serious implications for those co-infected with human immunodeficiency virus (HIV). Routine and frequent syphilis screening has the potential to ensure early detection and treatment, minimize disease burden, and help control the on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0371-0
更新日期:2016-01-16 00:00:00
abstract:BACKGROUND:Patients in control of their own haemodialysis report better outcomes than those receiving professional controlled care in a hospital setting, even though home and hospital haemodialysis are largely equivalent from mechanical and physiological perspectives. Shared Haemodialysis Care (SHC) describes an initia...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-118
更新日期:2013-10-07 00:00:00
abstract:BACKGROUND:Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0558-z
更新日期:2017-02-28 00:00:00
abstract:BACKGROUND:The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/s13012-017-0686-5
更新日期:2017-12-06 00:00:00
abstract:: Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-81
更新日期:2010-10-22 00:00:00
abstract:BACKGROUND:Uterine fibroids are non-cancerous overgrowths of the smooth muscle in the uterus. As they grow, some cause problems such as heavy menstrual bleeding, pelvic pain, discomfort during sexual intercourse, and rarely pregnancy complications or difficulty becoming pregnant. Multiple treatment options are availabl...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-019-0933-z
更新日期:2019-09-02 00:00:00
abstract:BACKGROUND:The last year of life is one of the most resource-intensive periods for people with cancer. Very little population-based research has been conducted on end-of-life cancer care in the Australian health care setting. The objective of this program is to undertake a series of observational studies examining reso...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0148-2
更新日期:2015-02-26 00:00:00
abstract:BACKGROUND:Integrated knowledge translation (IKT) refers to collaboration between researchers and decision-makers. While advocated as an approach for enhancing the relevance and use of research, IKT is challenging and inconsistently applied. This study sought to inform future IKT practice and research by synthesizing s...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0399-1
更新日期:2016-03-17 00:00:00
abstract:BACKGROUND:The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entail...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-7
更新日期:2010-01-29 00:00:00
abstract:BACKGROUND:Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of behavioral health provide...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-015-0313-2
更新日期:2015-09-07 00:00:00
abstract:BACKGROUND:Health practice guidelines (HPGs) are important tools for the translation of evidence into practice. Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist provides guidance on reporting health practice guidelines (HPGs). We assessed the reporting completeness and quality of a set of nationa...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0828-4
更新日期:2018-10-29 00:00:00
abstract:BACKGROUND:Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-21
更新日期:2006-09-27 00:00:00
abstract::Following publication of the original article [1], the authors reported an error in one of the authors' names. In this Correction the incorrect and correct author name are shown. The original article has been corrected. ...
journal_title:Implementation science : IS
pub_type: 杂志文章,已发布勘误
doi:10.1186/s13012-019-0862-x
更新日期:2019-02-08 00:00:00
abstract:BACKGROUND:The use of guidelines in general practice is not optimal. Although evidence-based methods to improve guideline adherence are available, variation in physician adherence to general practice guidelines remains relatively high. The objective for this study is to transfer a quality improvement strategy based on ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-6
更新日期:2009-02-17 00:00:00