Improving Uptake of a National Web-Based Psychoeducational Workshop for Informal Caregivers of Veterans: Mixed Methods Implementation Evaluation.
Improving Uptake of a National Web-Based Psychoeducational Workshop for Informal Caregivers of Veterans: Mixed Methods Implementation Evaluation.
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DOI：
10.2196/16495
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发表时间：
2021-01-07
影响因子：
7.4
通讯作者：
Asch SM
中科院分区：
文献类型：
--
作者：
Yank V;Gale RC;Nevedal A;Okwara L;Koenig CJ;Trivedi RB;Dupke NJ;Kabat M;Asch SM
虽然基于网络的心理教育计划可能是一个有效的，可访问的，可扩展的选择，以改善参与者的福祉，他们很少持续超过试验出版。执行评估可能有助于优化计划的吸收，但很少执行。当美国退伍军人事务部（VA）在2013年为全国退伍军人的非正式照顾者推出基于网络的心理教育研讨会“建立更好的照顾者”（BBC）时，研讨会并没有像预期的那样招募那么多的照顾者。本研究的目的是确定的优势和劣势，初步实施，战略可能会提高研讨会的吸收，VA是否采用了这些策略，以及研讨会招生是否改变。我们使用混合方法和促进行动的研究实施卫生服务（PARIHS）实施评估框架。在第一阶段，我们进行了半结构化的采访，照顾者，当地工作人员，地区和国家的VA领导人和调查的照顾者和工作人员。我们同时收集和分析调查和访谈数据，并整合结果，以确定实施的优势和劣势，以及可能提高研讨会吸收的策略。在第二阶段，我们重新采访了国家领导人，以确定退伍军人管理局是否采取了推荐的策略，并使用国家数据来确定研讨会的报名人数是否随着时间的推移而变化。共有54名护理人员（n=32，59%），工作人员（n=13，24%），区域（n=5，9%）和国家（n=4，7%）领导人进行了采访。我们收到了72%（23/32）的护理人员和77%（10/13）的当地工作人员的调查答复。在第1阶段，调查和访谈结果在多个PARIHS结构中是一致的。虽然低入学率中心的参与者报告了较少的实施优势和更多的弱点，但定性主题在高入学率和低入学率中心以及护理人员，工作人员和领导力应答组之间是一致的。所确定的优势包括相信讲习班会产生积极影响，以及采用了一些成功的外联办法。执行方面的弱点包括错失了改善外联和更好地支持当地工作人员的机会。从中，我们确定并推荐了新的和增强的实施策略--增加对外宣传和营销能力的投资;为多个利益相关者群体定制对外宣传策略;使用个性化、重复和详细的活动，并提供多种交付选项;对新员工进行经常性培训和指导;以及全面的数据管理和报告能力。在第二阶段，我们确定退伍军人事务部在2016年采取了其中几项战略。在收养前后的3年里，BBC的累计注册人数从2139人（2013-2015年）增加到4030人（2016-2018年）。这项研究扩展了有限的实施科学文献的最佳实践时，使用基于网络的心理教育计划。我们发现，强有力的外联和营销战略以及对当地工作人员的支持对英国广播公司讲习班的成功实施至关重要。其他卫生系统可能希望在实施基于网络的计划时部署这些策略。
Although web-based psychoeducational programs may be an efficient, accessible, and scalable option for improving participant well-being, they seldom are sustained beyond trial publication. Implementation evaluations may help optimize program uptake, but few are performed. When the US Department of Veterans Affairs (VA) launched the web-based psychoeducational workshop Building Better Caregivers (BBC) for informal caregivers of veterans nationwide in 2013, the workshop did not enroll as many caregivers as anticipated. This study aims to identify the strengths and weaknesses of initial implementation, strategies likely to improve workshop uptake, whether the VA adopted these strategies, and whether workshop enrollment changed. We used mixed methods and the Promoting Action on Research Implementation in Health Services (PARIHS) implementation evaluation framework. In stage 1, we conducted semistructured interviews with caregivers, local staff, and regional and national VA leaders and surveys with caregivers and staff. We collected and analyzed survey and interview data concurrently and integrated the results to identify implementation strengths and weaknesses, and strategies likely to improve workshop uptake. In stage 2, we reinterviewed national leaders to determine whether the VA adopted recommended strategies and used national data to determine whether workshop enrollment changed over time. A total of 54 caregivers (n=32, 59%), staff (n=13, 24%), and regional (n=5, 9%) and national (n=4, 7%) leaders were interviewed. We received survey responses from 72% (23/32) of caregivers and 77% (10/13) of local staff. In stage 1, survey and interview results were consistent across multiple PARIHS constructs. Although participants from low-enrollment centers reported fewer implementation strengths and more weaknesses, qualitative themes were consistent across high- and low-enrollment centers, and across caregiver, staff, and leadership respondent groups. Identified strengths included belief in a positive workshop impact and the use of some successful outreach approaches. Implementation weaknesses included missed opportunities to improve outreach and to better support local staff. From these, we identified and recommended new and enhanced implementation strategies—increased investment in outreach and marketing capabilities; tailoring outreach strategies to multiple stakeholder groups; use of campaigns that are personal, repeated, and detailed, and have diverse delivery options; recurrent training and mentoring for new staff; and comprehensive data management and reporting capabilities. In stage 2, we determined that the VA had adopted several of these strategies in 2016. In the 3 years before and after adoption, cumulative BBC enrollment increased from 2139 (2013-2015) to 4030 (2016-2018) caregivers. This study expands the limited implementation science literature on best practices to use when implementing web-based psychoeducational programs. We found that robust outreach and marketing strategies and support for local staff were critical to the implementation success of the BBC workshop. Other health systems may want to deploy these strategies when implementing their web-based programs.
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影响因子：
3
作者：
Lorig, Kate;Ritter, Philip L.;Yank, Veronica
通讯作者：
Yank, Veronica
DOI：
10.1186/1748-5908-5-46
发表时间：
2010-06-14
期刊：
Implementation science : IS
影响因子：
--
作者：
Hagedorn HJ;Heideman PW
通讯作者：
Heideman PW
影响因子：
5.2
作者：
Hermes E;Burrone L;Perez E;Martino S;Rowe M
通讯作者：
Rowe M
影响因子：
1.7
作者：
Neal, Jennifer Watling;Neal, Zachary P.;Kornbluh, Mariah
通讯作者：
Kornbluh, Mariah
影响因子：
7.2
作者：
Harvey, Gill;Kitson, Alison
通讯作者：
Kitson, Alison