{"title":"Occupational Therapists' Perspectives on Community Implementation of Interventions Unfamiliar to Older Adults.","authors":"Hui-Fen Mao, Athena Yi-Jung Tsai, Hsin-Chun Yeh, Ling-Hui Chang","doi":"10.1093/geront/gnae179","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>There is an increasing push for broad implementation of evidence-based interventions (EBIs) targeting older adults. Successful delivery of EBIs in communities requires therapists to adhere to protocols and to be responsive to contextual factors. This study explored the real-world implementation of an EBI, the Multiple-component Cognitive Intervention using Simulated Everyday Tasks (MCI-SET) in Taiwan from therapists' perspectives on fidelity, challenges, and strategies for program delivery.</p><p><strong>Research design and methods: </strong>We used a convergent mixed-methods design. Quantitative data were collected from the 13-item Perceived Fidelity Questionnaire (PFQ), assessing the perceived importance, proficiency, and adherence to the essential skills of MCI-SET. Qualitative data were collected via two World-Café discussions on implementation challenges and strategies, which were recorded, transcribed verbatim, and analyzed using thematic analysis. Quantitative and qualitative findings were then compared and integrated to enrich the interpretation.</p><p><strong>Results: </strong>Forty-seven occupational therapists completed the PFQ. They rated community-oriented skills as more important, demonstrated greater proficiency, and achieved higher adherence. Qualitative analysis revealed that therapists need to increase and sustain participation by strategically introducing the program, adapting the intervention protocol to make it engaging, relevant to everyday issues, and tailored to local needs, and building rapport. Both quantitative and qualitative findings highlighted the importance of community engagement skills and the adaptability of intervention to implementation and sustainability in communities.</p><p><strong>Discussion and implications: </strong>Real-world scale-up of evidence-based interventions requires tailored adaptations responsive to community contexts, especially when initially introducing an intervention unfamiliar to the community. This emphasizes the need for a dynamic fidelity concept.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gerontologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geront/gnae179","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: There is an increasing push for broad implementation of evidence-based interventions (EBIs) targeting older adults. Successful delivery of EBIs in communities requires therapists to adhere to protocols and to be responsive to contextual factors. This study explored the real-world implementation of an EBI, the Multiple-component Cognitive Intervention using Simulated Everyday Tasks (MCI-SET) in Taiwan from therapists' perspectives on fidelity, challenges, and strategies for program delivery.
Research design and methods: We used a convergent mixed-methods design. Quantitative data were collected from the 13-item Perceived Fidelity Questionnaire (PFQ), assessing the perceived importance, proficiency, and adherence to the essential skills of MCI-SET. Qualitative data were collected via two World-Café discussions on implementation challenges and strategies, which were recorded, transcribed verbatim, and analyzed using thematic analysis. Quantitative and qualitative findings were then compared and integrated to enrich the interpretation.
Results: Forty-seven occupational therapists completed the PFQ. They rated community-oriented skills as more important, demonstrated greater proficiency, and achieved higher adherence. Qualitative analysis revealed that therapists need to increase and sustain participation by strategically introducing the program, adapting the intervention protocol to make it engaging, relevant to everyday issues, and tailored to local needs, and building rapport. Both quantitative and qualitative findings highlighted the importance of community engagement skills and the adaptability of intervention to implementation and sustainability in communities.
Discussion and implications: Real-world scale-up of evidence-based interventions requires tailored adaptations responsive to community contexts, especially when initially introducing an intervention unfamiliar to the community. This emphasizes the need for a dynamic fidelity concept.
期刊介绍：
The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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