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Identifying unique barriers to implementing rural emergency department-based peer services for opioid use disorder through qualitative comparison with urban sites

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ADDICTION SCIENCE & CLINICAL PRACTICE 2022年第1期17卷 1页

作者： Watson, Dennis P. Staton, Monte D. Gastala, Nicole Chestnut Hlth Syst 221 W Walton St Chicago IL 60610 USA Univ Illinois Coll Med Dept Med Ctr Disseminat & Implementat Sci Chicago IL 60607 USA Univ Illinois Coll Med Mile Sq Hlth Ctr Dept Family Med Chicago IL USA

Background In an effort to address the current opioid epidemic, a number of hospitals across the United States have implemented emergency department-based interventions for engaging patients presenting with opioid use disorder. The current study seeks to address gaps in knowledge regarding implementation of a sub-type of such interventions, emergency department-based peer support services, in rural areas by comparing implementation of rural and urban programs that participated in Indiana's Recovery Coach and Peer Support Initiative (RCPSI). Methods: We conducted a secondary analysis of qualitative semi-structured implementation interviews collected as part of an evaluation of 10 programs (4 rural and 6 urban) participating in the RCPSI. We conducted interviews with representatives from each program at 3 time points over the course of the first year of implementation. Our deductive coding process was guided by the Consolidated Framework for implementation Research (CFIR) and an external context taxonomy. Results: We identified key differences for rural programs corresponding to each of the 5 primary constructs in the coding scheme. (1) Intervention characteristics: rural sites questioned intervention fit with their context, required more adaptations, and encountered unexpected costs. (2) External context: rural sites were not appropriately staffed to meet patient needs, encountered logistical and legal barriers regarding patient privacy, and had limited patient transportation options. (3) Inner setting: rural sites lacked strong mechanisms for internal communication and difficulties integrating with pre-existing culture and climate. (4) Characteristics of individuals: some rural providers resisted working with peers due to pre-existing attitudes and beliefs. (5) implementation process: rural sites spent more time identifying external partners and abandoned more components of their initial implementation plans. Conclusions: Findings demonstrate how rural programs face

关键词： Peer services Overdose Substance use disorder Behavioral health services program implementation implementation context

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Early childhood educator's implementation readiness and intervention fidelity: Findings from a person-centered study

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EARLY CHILDHOOD RESEARCH QUARTERLY 2023年 63卷 156-168页

作者： Bleses, Dorthe Willemsen, Marinka M. Purtell, Kelly M. Justice, Laura M. Slot, Pauline Dybdal, Line Hojen, Anders Aarhus Univ Sch Commun & Culture Aarhus C Denmark Aarhus Univ TrygFondens Ctr Child Res Aarhus Denmark Aarhus Univ Dept Econ & Business Econ Aarhus Denmark Aarhus Univ Ctr Integrated Register Based Res CIRRAU Aarhus Denmark Ohio State Univ Human Dev & Family Sci Columbus OH 43210 USA Ohio State Univ Dept Educ Studies Columbus OH 43210 USA Univ Utrecht Dept Child Family & Educ Studies Utrecht Netherlands Ramboll Management Consulting Aarhus Denmark

Research has indicated that early educators' intervention fidelity is a significant predictor of children's respon-siveness to classroom interventions. To improve understanding of predictors of intervention fidelity in early childhood settings, this study adopted a person-centered approach to identify profiles of "implementation readi-ness " in 1,192 Danish educators, and to examine relations with implementation fidelity. Multilevel latent profile analyses including setting-level characteristics as well as characteristics particular to the individual educator, showed reliable profiles of general and intervention-specific implementation readiness, which were associated with proportion of fulltime educators, employees with a teaching-related pre-service education, and investment in professional development. Higher and more positive implementation readiness predicted implementation dosage and adherence to early childhood interventions.

关键词： Early childhood education Intervention program implementation Fidelity Educator readiness Profiles

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Social influences predicting involvement in couple relationship education

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FAMILY RELATIONS 2023年第5期72卷 2610-2626页

作者： Garrison, Christine M. W. Totura Neely, Daniel McGill, Julianne Adler-Baeder, Francesca Auburn Univ Dept Psychol 210 Goodwyn Hall Montgomery AL 36117 USA Auburn Univ Dept Psychol Auburn AL USA Auburn Univ Human Dev & Family Studies Auburn AL USA

ObjectiveThis study explored the implementation climate of couple relationship education (CRE), specifically the positive role intimate partners, group members, and program facilitators have on one's beneficial involvement in *** CRE programs to be effective, participants need to be actively involved, yet little is known about social influences in the program encouraging participation in CRE. The perceived involvement of influential others was expected to moderate the relationship between intentions to participate and actual CRE involvement, with this involvement related to improvements in marital *** (584 men;M-age = 38.9 years and 627 women;M-age = 36.4 years) completed online surveys assessing study variables pre- and post-CRE *** intimate partner involvement contributed to better individual involvement and relationship quality for women with low intentions to participate in CRE, whereas both perceived partner and group involvement tended to have a protective effect for men's *** study primarily demonstrates the importance of the perception of one's intimate partner's involvement in predicting individual involvement in CRE *** predictors of program involvement assists with understanding the context of CRE effectiveness and skill acquisition for those intended to benefit.

关键词： couple relationship education marital quality program implementation program involvement social norms theory of planned behavior

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Measuring and predicting teachers' commitment to implementing evidence-based programs

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EARLY CHILDHOOD RESEARCH QUARTERLY 2023年第1期64卷 405-415页

作者： Cramer, Travis Cappella, Elise Morris, Pamela Ganimian, Alejandro NYU Dept Appl Psychol New York NY 10012 USA 246 Greene St Floor 8 New York NY 10003 USA

Practical wisdom and empirical evidence indicate that teachers' commitment to learn and enact a practice (i.e., their commitment to implement) is a critical but overlooked mechanism for supporting changes in teacher prac-tice. Shortcomings in this area of scholarship stem from research gaps regarding: (1) how to operationalize teach-ers' commitment to implementing new practices and (2) which factors predict whether teachers are committed to using new practices. To address these gaps, this study collected survey and open-ended response data from 107 early childhood education teachers implementing an evidence-based social-emotional learning program called Tools of the Mind (TotM). After comparing intention, planning, and motivation approaches for operationalizing teachers' commitment to implement, a motivation approach emerged as the most consistent and valid method. Teachers' belief that TotM would benefit children's development was identified as the strongest predictor of teach-ers' commitment to implement based on structural equation modeling and open-ended survey data. Findings are discussed in the context of implementation science and teacher workforce development.

关键词： Teacher motivation program implementation Professional development implementation science Teacher improvement Teacher attitudes

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Ensuring the Success of Pediatric Cardiology Patients Through the Lifespan: Translating Current Transition Medicine Research into programmatic implementation

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CURRENT PEDIATRICS REPORTS 2023年第4期11卷 193-203页

作者： Lee, Hannah Y. Lopez, Keila N. Columbia Univ Irving Med Ctr Div Pediat Cardiol 3959 Broadway Room 229 North New York NY 10032 USA Texas Childrens Hosp Baylor Coll Med Div Pediat Cardiol 6651 Main StSuite E1920 Houston TX 77030 USA

Purpose of ReviewThis paper will introduce transition medicine implementation ideas to adapt and incorporate into every major pediatric cardiology center. By examining existing research that demonstrates effective strategies aimed at improving the transition process for young adults with chronic illness, we hope to engage major stakeholders in developing and sustaining transition of care clinics (TOCC).Recent FindingsMany barriers exist to implementing a successful transition of care program for pediatric chronic disease populations. The divergent goals of research findings and the nuances of institutional funding priorities serve as a big driver of delay in transition program implementation. Adequate funding streams for research are also limited, with child health outcomes and care throughout the lifespan not gaining sufficient attention. Investment from institutional, local, state, and federal funding as well as increased legislative priorities in child health may help gain more traction in establishing TOCC. Lastly, advocacy surrounding the importance of TOCC and comparative effectiveness data on which transition programs improve outcomes for pediatric chronic disease populations is critical for best care practice, as well as the ability to disseminate data that can be easily translated by and disseminated to institutions and *** stakeholders, institutional prioritization, multi-level funding, and research translation are critical to enhancing and improving transition of care outcomes and experiences for pediatric chronic disease patients.

关键词： Pediatric to adult transition programs program implementation Congenital heart disease Transition of care Health policy Pediatric chronic illness Child advocacy Orthotopic heart transplant

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“Creating communities that care”: reflections from community leaders on Livability Academy, a neighborhood quality-of-life training program in Philadelphia

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Cities and Health 2023年第6期7卷 964-972页

作者： Dsouza, Nishita Monteiro, Stasia Mihinjac, Mateja Cuellar, Sierra Bell, Roxanne Moore, Benjamin Moses, Sheila Johnson, Wanda Ziebarth, Emilie Social Intervention Group Columbia School of Social Work New York NY United States Department of Community Engagement HACE Community Development Corporation Philadelphia PA United States Europe Region AlterNation Criminology Consulting Denver CO United States Department of Human Services Allegheny County Department of Human Services Pittsburgh PA United States Medical Department Esperanza Health Center Philadelphia PA United States

‘What does livability mean to us? Creating communities that care’. This reflective praxis think-piece was a collective effort by graduates of the Livability Academy program, a community leadership program hosted in eastern North Philadelphia. program participants worked in teams to implement programs to improve neighborhood quality of life, as those involved in implementing Livability Academy collaborated to strengthen the bottom-up, asset-based, network-driven model. Our reflections on successes and areas for improvement can strengthen future cohorts of Livability Academy and keep us connected to continue making our neighborhoods more livable. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

关键词： community development Livability local capacity building program implementation quality of life

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Financial incentives and moral distress in Australian audiologists and audiometrists

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Clinical Ethics 2023年第1期18卷 20-25页

作者： Simpson, Andrea Fawcett, Meg McLeod, Lily Lin, Jennifer Tuncer, Selda Sarkic, Bojana Charles Darwin University Casuarina Australia La Trobe University Bundoora Australia Country Hearing Care Mildura Australia Bloom Hearing Specialists Melbourne Australia Amplifon Melbourne Australia

Introduction: Financial incentive schemes have been commonly used by the hearing aid industry as a way of encouraging device sales. These schemes can lead to a conflict of interest as the hearing device dispenser is torn between personal reward over the best interests of their client. This conflict of interest has the potential for the dispenser to develop “moral distress”, a negative state of mind when an individual’s ethical values contrast with those of the employing organization. The purpose of this study was to investigate if there was a relationship between financial incentives and moral distress in Australian audiologists and audiometrists. Methods: An online survey was distributed to all members of Audiology Australia and the Australian College of Audiology via email. Participants rated their perceived moral distress from 0 to 10 on the Moral Distress Thermometer and answered four questions about financial incentives in their respective workplace. Results: A total of 65 participants, 42 females and 23 males, completed the online survey. A quarter of participants rated their moral distress corresponding to levels of uncomfortable or above. A statistically significant association was found between financial incentives, sales target setting, and higher perceived moral distress in participants. Conclusions: For our sample, the implementation of financial incentives created ethical challenges for practicing audiologists and audiometrists. Modifications to employee rewards programs as well as a regulation of device sales are recommended. © The Author(s) 2022.

关键词： Audiology Audiometry Ethics Financial Incentives Hearing Aids Moral Distress program implementation

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Evaluation of the implementation of the Healthy Start program: Findings from the 2016 National Healthy Start program Survey

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MATERNAL AND CHILD HEALTH JOURNAL 2019年第2期23卷 220-227页

作者： Parasuraman, Sarika Rane de la Cruz, David Hlth Resources & Serv Adm Off Res & Epidemiol Maternal & Child Hlth Bur US Dept HHS 5600 Fishers Lane Rockville MD 20857 USA Hlth Resources & Serv Adm US PHS Div Hlth Start & Perinatal Serv Maternal & Child Hlth BurUS Dept HHS 5600 Fishers Lane Rockville MD 20857 USA

Objectives The Healthy Start program has taken a community-based approach to improving maternal and child health outcomes among underserved populations for 25 years. Although the program has been evaluated in the past, it has not undergone a national evaluation since it was transformed in 2014. The purpose of this study is to present data from an early component of the latest national evaluation-the 2016 National Healthy Start program Survey, which includes information describing grantees, the risk profile of participants served, and the scope of services offered to meet participant needs. Methods Ninety-five grantees completed the survey, and responses are reported at the aggregate level. Study analyses are descriptive. Results Grantees reported serving a population with a high-risk profile characterized by chronic medical conditions or risk behaviors. Most grantees conduct comprehensive needs/risk assessments for participants upon program entry, yet service delivery strategies were mixed, with some differences found by geographic region. Grantees provide a core set of services to participants, including case management and health promotion/education, and tend to refer participants to community providers for services that are deemed appropriate during individual risk assessments. While most grantees have protocols in place related to these priority services, participants may not have been universally offered all services across sites. Conclusions for Practice Although grantees often highlight their facilitation of service/care coordination with existing resources, findings suggest potential areas on which to focus strategic efforts to ensure that the Healthy Start program is successfully bridging gaps in access and utilization of services for underserved communities.

关键词： Healthy Start program implementation Community health Evaluation

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The Life Cycle of STEMM Intervention programs: From Adoption to Institutionalization

The Life Cycle of STEMM Intervention Programs: From Adoption...

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作者： Perez, Edwin Jose University of California Los Angeles

学位级别：Ph.D., Doctor of Philosophy

Severe inequities for underrepresented student groups (URGs) in Science, Technology, Engineering, Mathematics, and Medicine (STEMM) fields has remained a topic of national concern for several decades. Research has demonstrated the efficacy of STEMM intervention programs (SIPs) in addressing disparate STEMM outcomes. However, there is a dearth of research that has examined the process of developing, implementing, and sustaining programs. Using a multiple case study approach and organizational theory, this study tracks the life cycle of the Chancellor’s Science Scholars program at UNC-Chapel Hill and the Millennium Scholars program at Penn State (University Park), two SIPs modeled after the nationally successful Meyerhoff Scholars program at the University of Maryland, Baltimore County. This study provides campuses with important practical and theoretical implications regarding distinct phases of SIPs. Results demonstrate that unique challenges emerge at each phase of the life cycle, requiring programs to employ multiple strategies to find success. At the implementation phase, campuses navigated logistical challenges determining program placement, setting up a funding model, and integrating into the existing ecosystem of programs and diversity initiatives. Additionally, the cultural contours of UNC-Chapel Hill and Penn State, two predominantly white research-intensive universities, were at odds with the Meyerhoff program features derived from an HBCU model. Addressing these cultural challenges required several adaptations to the model leading to unintended consequences but also some that enhanced diversity, equity, and inclusion (DEI). Sustainability was achieved through garnering buy-in and commitment from organizational members across, and at multiple levels, of the institution. Additionally, programs were sustained through: shifts in their organizational placement and funding models, helping to advance their institutions’ espoused DEI goals, and demonstrating their

关键词： Organizational change program implementation program sustainability Intervention programs Institutionalization

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Leveraging the Scaling Up Nutrition Movement to Operationalize Stunting Prevention Activities: implementation Lessons From Rural Malawi

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FOOD AND NUTRITION BULLETIN 2022年第1期43卷 104-120页

作者： Kodish, Stephen R. Farhikhtah, Arghanoon Mlambo, Trust Hambayi, Mutinta Nseluke Jones, Vanessa Aburto, Nancy J. United Nations World Food Programme Headquarters Rome Italy Penn State Univ University Pk PA 16802 USA Food & Agr Org United Nat Vialle Terme Caracalla I-00153 Rome Italy United Nations World Food Programme Lilongwe Malawi

Background: The rural district of Ntchisi is in the central region of Malawi. Among children aged 6 to 23 months, the stunting prevalence is 40% to 50%. To address this high prevalence, the World Food programme, with cooperating partners, supported the Government of Malawi to implement an integrated stunting prevention program entitled The Right Foods at the Right Time from 2013 to 2018. Objective: To provide implementation lessons learned from systematic documentation of how the Scaling Up Nutrition (SUN) movement, combined with other international and national initiatives and policies, was translated into tailored programming. Methods: During program conception, early design, and implementation, this descriptive study systematically documented the process of translating SUN principles and government policies into an operational stunting prevention program in rural Malawi. Results: We identified 8 factors that contributed to successful translation of policy into program activities: (1) well-structured National SUN framework, (2) reliable coordination platforms and district ownership, (3) systematic and evidence-informed program design, (4) multiple forms of data used to inform program planning, (5) multisectoral implementation approaches to stunting prevention, (6) innovation in technology to improve overall program efficiency, (7) systematic collaboration among diverse stakeholders, and (8) strong public health nutrition capacity of program team members. Conclusions: Lessons from this nutrition program in Ntchisi, Malawi, provide one case illustrating how the SUN movement, government policies, and global evidence base can be operationalized into tailored programming for improving nutrition.

关键词： Scaling Up Nutrition stunting infant and young child feeding (IYCF) stakeholder engagement program implementation

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