Abstract:
BACKGROUND:Community health worker (CHW)-delivered support visits to children living with HIV and their caregivers significantly reduced odds of virological failure among the children in the ZENITH trial conducted in Zimbabwe. We conducted a process evaluation to assess fidelity, acceptability, and feasibility of this intervention to identify lessons that could inform replication and scale-up of this approach. METHODS:Field manuals kept by each CHW, records from monthly supervisory meetings, and participant data collected throughout the trial were used to assess the intervention's implementation. Data extracted from field manuals included visit type, content, and duration. Minutes from monthly supervisory meetings were used to capture CHW attendance. RESULTS:The trial enrolled 172 participants in the intervention arm of whom 5 subsequently refused all visits, 1 died before the intervention could be delivered, and 1 could not be located. Manuals for 8 participants were not returned, 3 were incorrectly entered, and 1 manual was lost. We had 154 manuals available for analysis. A total of 1553 visits were successfully conducted (median 11 per participant, range 1-20). Additionally, CHWs made 85 visits where they were unable to make contact with the family. Thirteen (8.4%) participants received 5 or fewer visits, 10 moved out of the study area, and 3 died. CHWs discussed disclosure with the child/family for over 89% of participants and assisted clients with developing and reviewing their personal treatment plan with over 85% of participants. Of the 20 CHWs (3 male, 17 female) selected to implement the intervention, 19 were retained at the end of the trial. CONCLUSIONS:The intervention was acceptable to participants with most receiving and accepting the required number of visits. Key strenghts were high staff retention and fidelity to the intervention. This community-based intervention was an acceptable and feasible approach to reduce virological failure among children living with HIV. TRIAL REGISTRATION:The ZENITH trial was registered on 25 October 2012 in the Pan African Clinical Trials Registry under the trial registration number PACTR201212000442288 . It can be found at http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR201212000442288 .
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Dziva Chikwari C,Simms V,Busza J,Dauya E,Bandason T,Chonzi P,Munyati S,Mujuru H,Ferrand RAdoi
10.1186/s13012-018-0762-5subject
Has Abstractpub_date
2018-05-23 00:00:00pages
70issue
1issn
1748-5908pii
10.1186/s13012-018-0762-5journal_volume
13pub_type
杂志文章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:General dental practitioners (GDPs) regularly prescribe antibiotics to manage dental infections although most infections can be treated successfully by local measures. Published guidance to support GDPs to make appropriate prescribing decisions exists but there continues to be wide variation in dental antibi...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0372-z
更新日期:2016-01-29 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: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:Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level ...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-8-22
更新日期:2013-02-17 00:00:00
abstract:BACKGROUND:The impact of efforts by healthcare organizations to enhance the use of evidence to improve organizational processes through training programs has seldom been assessed. We therefore endeavored to assess whether and how the training of mid- and senior-level healthcare managers could lead to organizational cha...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-53
更新日期:2014-05-02 00:00:00
abstract::As more quality improvement programs are implemented to achieve gains in performance, the need to evaluate their lasting effects has become increasingly evident. However, such long-term follow-up evaluations are scarce in healthcare implementation science, being largely relegated to the "need for further research" sec...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-21
更新日期:2008-04-22 00:00:00
abstract:BACKGROUND:Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. T...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-8
更新日期:2006-03-31 00:00:00
abstract:BACKGROUND:A large proportion of artemisinin-combination therapy (ACT) anti-malarial medicines is consumed by individuals that do not have malaria. The over-consumption of ACTs is largely driven by retail sales in high malaria-endemic countries to clients who have not received a confirmatory diagnosis. This study aims ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01077-w
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:The fields of implementation and improvement sciences have experienced rapid growth in recent years. However, research that seeks to inform health care change may have difficulty translating core components of implementation and improvement sciences within the traditional paradigms used to evaluate efficacy ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0770-5
更新日期:2018-05-29 00:00:00
abstract:BACKGROUND:We sought to determine whether a multi-modal intervention, which included mailing a patient reminder with a colon cancer decision aid to patients and system changes allowing direct access to scheduling screening tests through standing orders, would be an effective and efficient means of promoting colon cance...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-32
更新日期:2008-06-02 00:00:00
abstract:BACKGROUND:Improved quality of care is a policy objective of health care systems around the world. Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice, and hence to reduce inappropriate care. It includes the study of in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-52
更新日期:2008-12-17 00:00:00
abstract:BACKGROUND:Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners' capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wan...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-015-0272-7
更新日期:2015-05-29 00:00:00
abstract::Implementing research findings into healthcare practice and policy is a complex process occurring in diverse contexts; it invariably depends on changing human behaviour in many parts of an intricate implementation system. Questions asked with the aim of improving implementation are multifarious variants of 'What works...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-017-0660-2
更新日期:2017-11-14 00:00:00
abstract:BACKGROUND:Patients with chronic illness typically receive ambulatory treatment from multiple health professionals. Connectedness between these professionals may influence their clinical decisions and the coordination of patient care. We aimed to describe and analyze connectedness in a regional network of health profes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-67
更新日期:2011-07-03 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:Visit preparation interventions help patients prepare to meet with a medical provider. Systematic reviews have found some positive effects, but there are no reports describing implementation experiences. Consultation Planning (CP) is a visit preparation technique in which a trained coach or facilitator elici...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-6
更新日期:2008-01-31 00:00:00
abstract:BACKGROUND:Evidence-based health promotion programs developed and tested in the general population typically exclude people with disabilities. To address this gap, a set of methods and criteria were created to adapt evidence-based health promotion programs for people with disabilities. In this first study, we describe ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0100-5
更新日期:2014-08-14 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:Intervention effects observed in efficacy trials are rarely replicated when the interventions are broadly disseminated, underscoring the need for more information about factors influencing real-life implementation and program impact. Using data from the ongoing national implementation of an evidence-based HI...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0539-7
更新日期:2017-02-10 00:00:00
abstract:BACKGROUND:Substance misuse is now encountered in settings beyond addiction specialty care, with schools a point-of-contact for student access to behavioral health services. Marijuana is a leading impetus for adolescent treatment admissions despite declining risk perception, for which the Teen Marijuana Check-Up (TMCU)...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0633-5
更新日期:2017-08-10 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:PURPOSE:The purpose of this study was to undertake a systematic assessment of the need for research-based information by decision-makers working in community-based organizations. It is part of a more comprehensive knowledge transfer and exchange strategy that seeks to understand both the content required and the format...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-2-20
更新日期:2007-07-03 00:00:00
abstract:BACKGROUND:There are recognised gaps between evidence and practice in general practice, a setting posing particular implementation challenges. We earlier screened clinical guideline recommendations to derive a set of 'high-impact' indicators based upon criteria including potential for significant patient benefit, scope...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0479-2
更新日期:2016-08-08 00:00:00
abstract:BACKGROUND:Facilitation has been identified in the literature as a potentially key component of successful implementation. It has not, however, either been well-defined or well-studied. Significant questions remain about the operational definition of facilitation and about the relationship of facilitation to other inte...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-23
更新日期:2006-10-18 00:00:00
abstract:BACKGROUND:In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was ther...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0283-4
更新日期:2015-06-30 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:Cerebral palsy is a permanent disorder of posture and movement caused by disturbances in the developing brain. It affects approximately 1 in every 500 children in developed countries and is the most common form of childhood physical disability. People with cerebral palsy may also have problems with speech, v...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0202-0
更新日期:2015-02-06 00:00:00
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 ...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-018-0720-2
更新日期:2018-02-08 00:00:00
abstract:BACKGROUND:Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted be...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-28
更新日期:2006-11-21 00:00:00