Implementation Flashcards
(18 cards)
Evidence
Complex cycle of observation, theory and experiment.
Depending on study design, Systematic reviews and meta-analyses of RCTs have better evidence of causation
Evidence based intervention
Programs, practices, principles, procedures, products, pills, and policies
Found to be effective at improving health behaviors, health outcomes, or health-related environments in one or more well-designed research studies.
If EBIs widely & effecitvely implemented > Reduction of high % diseases
THE THING (innovation or EBIs)
Sources of EBIs
- Systematic review recommendations (Strongest source, dont tell you how to implement)
- Packaged/bundled interventions (Detailed guidance of implementation and delivery but few fall into this category)
- Reports of intervention studies (most current info, reports of intervention for speicifc context, population or setting)
Steps to search
1. Systematic reviews for broad EBIs
2. Websites for packaged EBIs
3. Peer literatura to update and fill gaps
Know-do gaps
Gaps between what we know works and what we do in practice
Contributes to racial, socio-econ & other disparities in health outcomes
Implementation
- Book simple: Putting that “something that they are implementing” into practice
- Book complete: Purposeful actions taken to put an EBI into practice or into use.
- Slides: Use of strategies to adpt and integrate EB health interventions anc change practice patterns within and across specific systems
Purposeful, Action, Temporally bounded.
Implementation science
- Book: multidisciplinary field designed to generate evidence to explain and predict translation of research results and EBIs into practice settings to improve public health.
- Easy:
- Slides: Scientific investigations that support movement of evidece based, effective health care approaches from the clinical knowledge base into routine use.
Created to close the know-do gaps and realize the impact of EBIs
Effectiveness
- Slides: Assess how an intervention that has demonstrated efficacy, functions in practice
WHETHER THE THING WORKS
Implementation strategies
THE STUFF WE DO TO TRY TO HELP PEOPLE PLACES TO THE THING
ERIC
Main Implementation outcomes
HOW MUCH, AND HOW WELL THEY DO THE THING
Adoption
Implementation can be viewed as a stage or phase of activity that is preceded by the decision to make use of an EBI
Sustainment
Continued use of an EBI
Implementation research
Scientific study of the use of strategies to adopt and integrate EBIs into clinical and community settings to improve individual outcomes and benefit population health.
How can we effectively & efficiently get people to use research results and EBI in a consistent high quality way?
or
HOW BEST HELP PEOPLE/PLACES DO THE THING
Dissemination research
Scientific** study of targeted distribution of information and intervention materials** to a specific public health or clinical practice audience.
How can we use theory and evidence to bet communicate and intergate knowledge and EBIs into new settings?
Implementation science for LMICs
How do we get what works to people who need it with greater speed, fidelity, efficiency, sustainability, and relevant coverage?
EBI implementation guided by
- Organizational inertia (we have always done it this way)
- Personal preferences (lets do it my way)
- ISLAGIATT principle (it seemed like a good idea at the time)
What is needed is evidence based implementation of EBIs.
Determinants
Barriers and facilitators that assist or impede implementation
CFIR tool
Traditional vs Improved
Research Pipeline
Traditional
1. Study efficacy
2. Study effectiveness
3. Improve outcomes
Improved
1. Study efficacy
2. Study effectiveness
!!!! Study implementation !!!!
3. Improve outcomes
EVIDENCE BASED GRAPHIC
- EBIs: THE THING
- Effectiveness research: Whether the THING WORKS
- Impementation research: STUDYING HOW BEST TO HELP PEOPLE AND PLEACES DO THE THING
- Implementation strategies: STUFF WE DO TO TRY TO HELP PEOPLE AND PLACES DO THE THING
- MAIN IMPLEMENTATION OUTCOMES: HOW MUCH AND HOW WELLL THEY DO THE THING?
