Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics.
Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics.
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DOI：
10.1177/26334895231164585
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发表时间：
2023-01
影响因子：
--
通讯作者：
Harper, Gary W.
中科院分区：
文献类型：
--
作者：
Naar, Sylvie;Fernandez, M. Isabel;Todd, Lisa;Green, Sara K. Shaw;Budhwani, Henna;Carcone, April;Coyle, Karin;Aarons, Gregory A.;MacDonell, Karen;Harper, Gary W.
关键词：
了解实现完成的障碍和促进因素对于确定为什么有些实现工作失败而有些成功至关重要。这些研究为制定进一步的战略提供了基础，以支持在扩大基于证据的实践（如动机性访谈）时完成实施。这项混合方法研究在迭代分析设计中使用了探索、准备、实施和维持框架，以比较在定制动机访谈的混合III型试验背景下表现出高或低实施完成率的青少年艾滋病诊所。根据坚持执行战略的三个组成部分的工作人员的百分比，将10个诊所分配到三个完成类别（高、中、低）中的一个。工作人员质性访谈对比分析对三家高完成度门诊和三家低完成度门诊进行了比较和对比。结果表明，与低完成度诊所相比，高完成度诊所有几个不同的因素，包括乐观情绪、解决问题的障碍、领导能力、员工压力和离职。针对这些因素的实施策略可以添加到EBP实施包中，以提高实施的成功率。虽然研究已经开始解决对干预技术的依从性，但这是第一个解决组织对实施策略的依从性的研究之一。来自不同学科的青年艾滋病毒提供者完成了关于内部和外部环境中支持或阻碍组织遵守实施战略的关键因素的访谈。与不那么坚持的诊所相比，更多坚持的诊所报告了更多的乐观主义，解决问题的能力和领导能力，更少的员工压力和流动率。可以将处理这些因素的实施策略添加到实施包中，以提高实施的成功率。
Understanding the barriers and facilitators of implementation completion is critical to determining why some implementation efforts fail and some succeed. Such studies provide the foundation for developing further strategies to support implementation completion when scaling up evidence-based practices (EBPs) such as Motivational Interviewing. This mixed-methods study utilized the Exploration, Preparation, Implementation, and Sustainment framework in an iterative analytic design to compare adolescent HIV clinics that demonstrated either high or low implementation completion in the context of a hybrid Type III trial of tailored motivational interviewing. Ten clinics were assigned to one of three completion categories (high, medium, and low) based on percentage of staff who adhered to three components of implementation strategies. Comparative analysis of staff qualitative interviews compared and contrasted the three high-completion clinics with the three low-completion clinics. Results suggested several factors that distinguished high-completion clinics compared to low-completion clinics including optimism, problem-solving barriers, leadership, and staff stress and turnover. Implementation strategies targeting these factors can be added to EBP implementation packages to improve implementation success. While studies have begun to address adherence to intervention techniques, this is one of the first studies to address organizational adherence to implementation strategies. Youth HIV providers from different disciplines completed interviews about critical factors in both the inner and outer context that can support or hinder an organization's adherence to implementation strategies. Compared to less adherent clinics, more adherent clinics reported more optimism, problem-solving, and leadership strengths and less staff stress and turnover. Implementation strategies addressing these factors could be added to implementation packages to improve implementation success.
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影响因子：
3.2
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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