10th Annual Dissemination and Implementation Conference
Arlington, VA | December 4-6, 2017
Assessing the balance between fidelity and adaptation in implementation strategies to support primary care practices in improving cardiovascular preventive care
Authors: Bijal A. Balasubramanian, Deborah J. Cohen, Shannon Sweeney, Miguel Marino, David Ezekiel-Herrera, Rikki Ward, Leah Gordon, Benjamin F. Crabtree, Leif Solberg
Findings: Intervention fidelity and adaptation emerged as a multi-level construct operational at the cooperative and practice levels. At the cooperative level, external practice facilitators were encouraged to use an overarching conceptual framework and specific support activities with each participating clinic, but there was considerable variation in the extent to which cooperatives encouraged and allowed tailoring those activities to the needs and desires of individual practices. At the practice level, facilitator interview and log data showed significant variation across practices in number, duration, and mode of facilitator encounters as well as in types of support activities provided. For example, facilitators in one cooperative delivered the planned 15 visits over the intervention period while others tailored the number and duration of facilitator visits to the needs of the practice so that number of visits ranged from 5 to 48 over one year.
Specifying implementation strategies used by seven primary care regional cooperatives: Real-world meets theory
Authors: Jennifer Hemler, Laura Damschroder, Cynthia Perry, Tanisha Tate Woodson, Sarah Ono, Deborah Cohen
Findings: Cooperatives’ implementation support used ERIC strategies across all nine ERIC clusters of strategies. We needed to create new terminology to fully capture forms of support that are not represented in ERIC: for instance, “Data Infrastructure” is not fully described within ERIC, although some components are included in multiple strategies across four different ERIC clusters. These discrete strategies may better reflect the reality of on-the-ground implementation if they were organized under a single cluster. Furthermore, Cooperatives’ Facilitation includes use of ERIC implementation strategies from 8 different ERIC clusters; this strategy is an overarching strategy that relies on other more narrowly focused strategies. We offer refined ERIC definitions, identify new strategies, and reorganize ERIC clusters to better align with implementation strategies as they occur in the real world.
Invited Plenary: The Next Generation of D&I Research
Presenter: Deborah Cohen
Focus: Advances in data infrastructure and technology while examining ways in which the field can maximize the use of these innovations.