Site‐initiated adaptations in the implementation of an evidence‐based inpatient walking program.
Background: There is increasing recognition of the importance of maximizing program‐setting fit in scaling and spreading effective programs. However, in the context of hospital‐based mobility programs, there is limited information on how settings could consider local context and modify program chara...
| Publicado en: | Journal of the American Geriatrics Society Vol. 72; no. 10; pp. 3210 - 3219 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Wiley-Blackwell
Oct2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=180150731&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 180150731 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Oct2024 vid: 72 iid: 10 pid: 480 pub: Wiley-Blackwell artinfo: ui: 180150731 10.1111/jgs.19044 ppf: 3210 ppct: 9 formats: tig: atl: Site‐initiated adaptations in the implementation of an evidence‐based inpatient walking program. aug: au: Hughes, Jaime M. Choate, Ashley L. Meyer, Cassie Kappler, Caitlin B. Wang, Virginia Allen, Kelli D. Van Houtven, Courtney H. Hastings, S. Nicole Zullig, Leah L. affil: Department of Implementation Science, Wake Forest University School of Medicine, Winston‐Salem North Carolina,, USA Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston‐Salem North Carolina,, USA Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham North Carolina,, USA Department of Population Health Sciences, Duke University School of Medicine, Durham North Carolina,, USA Department of Medicine, Duke University School of Medicine, Durham North Carolina,, USA Duke‐Margolis Center for Health Policy, Duke University, Durham North Carolina,, USA Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill North Carolina,, USA Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham North Carolina,, USA su: North Carolina United States United States. Dept. of Veterans Affairs Human services programs Hospital care Evaluation of human services programs Randomized controlled trials Psychological adaptation Psychology of veterans Attention Research funding Statistical sampling Walking Cluster sampling Group medical appointments Eligibility (Social aspects) Evidence-based medicine Physical mobility sug: subj: Human services programs Hospital care Evaluation of human services programs Randomized controlled trials Psychological adaptation Psychology of veterans Attention North Carolina United States United States. Dept. of Veterans Affairs Marketing Research and Public Opinion Polling Administration of Veterans' Affairs Research funding Statistical sampling Walking Cluster sampling Group medical appointments Eligibility (Social aspects) Evidence-based medicine Physical mobility keyword: adaptation implementation science mobility veterans adaptation implementation science mobility veterans ab: Background: There is increasing recognition of the importance of maximizing program‐setting fit in scaling and spreading effective programs. However, in the context of hospital‐based mobility programs, there is limited information on how settings could consider local context and modify program characteristics or implementation activities to enhance fit. To fill this gap, we examined site‐initiated adaptations to STRIDE, a hospital‐based mobility program for older Veterans, at eight Veterans Affairs facilities across the United States. Methods: STRIDE was implemented at eight hospitals in a stepped‐wedge cluster randomized trial. During the pre‐implementation phase, sites were encouraged to adapt program characteristics to optimize implementation and align with their hospital's resources, needs, and culture. Recommended adaptations included those related to staffing models, marketing, and documentation. To assess the number and types of adaptations, multiple data sources were reviewed, including implementation support notes from site‐level support calls and group‐based learning collaborative sessions. Adaptations were classified based on the Framework for Reporting Adaptations and Modifications‐Enhanced (FRAME), including attention to what was adapted, when, why, and by whom. We reviewed the number and types of adaptations across sites that did and did not sustain STRIDE, defined as continued program delivery during the post‐implementation period. Results: A total of 25 adaptations were reported and classified across seven of the eight sites. Adaptations were reported across five areas: program documentation (n = 13), patient eligibility criteria (n = 5), program enhancements (n = 3), staffing model (n = 2), and marketing and recruitment (n = 2). More than one‐half of adaptations were planned. Adaptations were common in both sustaining and non‐sustaining sites. Conclusions: Adaptations were common within a program designed with flexible implementation in mind. Identifying common areas of planned and unplanned adaptations within a flexible program such as STRIDE may contribute to more efficient and effective national scaling. Future research should evaluate the relationship between adaptations and program implementation. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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