Tracking implementation strategies in real-world settings: VA Office of Rural Health enterprise-wide initiative portfolio

IF 3.1 2区医学 Q2 HEALTH CARE SCIENCES & SERVICES Health Services Research Pub Date : 2024-09-03 DOI:10.1111/1475-6773.14377

Heather Schacht Reisinger PhD, Sheila Barron PhD, Erin Balkenende MPH, Melissa Steffen MPH, Kenda Steffensmeier PhD, Chris Richards MA, Dan Ball PhD, Emily E. Chasco PhD, Jennifer Van Tiem PhD, Nicole L. Johnson PhD, DeShauna Jones PhD, Julia E. Friberg MPH, Rachael Kenney MA, PMP, Jane Moeckli PhD, Kanika Arora PhD, Borsika Rabin PhD, MPH, PharmD

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Abstract

Objective

To use a practical approach to examining the use of Expert Recommendations for Implementing Change (ERIC) strategies by Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) dimensions for rural health innovations using annual reports on a diverse array of initiatives.

Data Sources and Study Setting

The Veterans Affairs (VA) Office of Rural Health (ORH) funds initiatives designed to support the implementation and spread of innovations and evidence-based programs and practices to improve the health of rural Veterans. This study draws on the annual evaluation reports submitted for fiscal years 2020–2022 from 30 of these enterprise-wide initiatives (EWIs).

Study Design

Content analysis was guided by the RE-AIM framework conducted by the Center for the Evaluation of Enterprise-Wide Initiatives (CEEWI), a Quality Enhancement Research Initiative (QUERI)-ORH partnered evaluation initiative.

Data Collection and Extraction Methods

CEEWI analysts conducted a content analysis of EWI annual evaluation reports submitted to ORH. Analysis included cataloguing reported implementation strategies by Reach, Adoption, Implementation, and Maintenance (RE-AIM) dimensions (i.e., identifying strategies that were used to support each dimension) and labeling strategies using ERIC taxonomy. Descriptive statistics were conducted to summarize data.

Principal Findings

A total of 875 implementation strategies were catalogued in 73 reports. Across these strategies, 66 unique ERIC strategies were reported. EWIs applied an average of 12 implementation strategies (range 3–22). The top three ERIC clusters across all 3 years were Develop stakeholder relationships (21%), Use evaluative/iterative strategies (20%), and Train/educate stakeholders (19%). Most strategies were reported within the Implementation dimension. Strategy use among EWIs meeting the rurality benchmark were also compared.

Conclusions

Combining the dimensions from the RE-AIM framework and the ERIC strategies allows for understanding the use of implementation strategies across each RE-AIM dimension. This analysis will support ORH efforts to spread and sustain rural health innovations and evidence-based programs and practices through targeted implementation strategies.

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跟踪真实世界环境中的实施战略：退伍军人事务部农村卫生办公室全企业倡议组合。

目标：采用一种实用的方法，利用有关各种倡议的年度报告，按照农村卫生创新的覆盖面、有效性、采用、实施和维护（RE-AIM）维度，对实施变革的专家建议（ERIC）战略的使用情况进行检查：退伍军人事务局（VA）农村健康办公室（ORH）资助旨在支持创新和循证计划与实践的实施和推广的项目，以改善农村退伍军人的健康状况。本研究借鉴了其中 30 项全企业倡议（EWIs）在 2020-2022 财年提交的年度评估报告：研究设计：内容分析以全企业倡议评估中心（CEEWI）的 RE-AIM 框架为指导，CEEWI 是质量提升研究倡议（QUERI）--ORH 合作评估倡议：CEEWI 分析师对提交给 ORH 的企业范围倡议年度评估报告进行了内容分析。分析包括按 "到达"、"采用"、"实施 "和 "维持"（RE-AIM）维度对报告的实施策略进行编目（即确定用于支持每个维度的策略），并使用 ERIC 分类法对策略进行标注。对数据进行了描述性统计：在 73 份报告中，共对 875 种实施策略进行了编目。在这些策略中，有 66 项独特的 ERIC 策略被报告。EWI 平均采用了 12 种实施策略（范围为 3-22）。在所有 3 年中，ERIC 中排名前三位的是发展利益相关者关系（21%）、使用评估/迭代策略（20%）和培训/教育利益相关者（19%）。大多数战略都是在实施维度中报告的。此外，还比较了符合乡村基准的环境工作机构的策略使用情况：将RE-AIM框架的各个维度与ERIC策略相结合，可以了解RE-AIM各个维度中实施策略的使用情况。这项分析将支持 ORH 通过有针对性的实施策略来推广和维持农村健康创新以及循证计划和实践。

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来源期刊

Health Services Research 医学-卫生保健

CiteScore

4.80

自引率

5.90%

发文量

193

审稿时长

4-8 weeks

期刊介绍： Health Services Research (HSR) is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health care administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities.