Inner and outer setting factors that influence the implementation of the National Diabetes Prevention Program (National DPP) using the Consolidated Framework for Implementation Research (CFIR): a qualitative study.
Inner and outer setting factors that influence the implementation of the National Diabetes Prevention Program (National DPP) using the Consolidated Framework for Implementation Research (CFIR): a qualitative study.
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DOI：
10.1186/s43058-022-00350-x
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发表时间：
2022-10-01
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扩大循证干预措施是影响人口健康的关键。国家DPP生活方式改变计划就是这样一种干预措施，在过去20年中已在美国各地推广;然而，招募是一个持续的挑战。此外，人们对哪些组织在项目交付、注册和扩展方面最成功知之甚少。本研究的目的是了解更多的内部和外部的组织因素，影响程序的执行和达到。在2020年8月至2021年1月期间，通过对30家全国DPP交付组织实施者的半结构化关键知情人访谈收集数据。本研究采用了定性的跨案例结构评级方法来评估实施研究的综合框架（CFIR）内部和外部设置结构的贡献（无论是在效价和幅度），该组织的当前水平的实施范围（衡量平均参与者每年注册）。创建了一个案例矩阵的结构，每个CFIR结构的受访者和实施达到水平分组的评级。在16个内部和外部环境结构和子结构中，每年入学人数较多的受访者提供了与该计划的实施和入学相关的更强和更积极的例子，而低覆盖率组报告了更强和更消极的例子。四个内部设置结构/子结构（结构特征，兼容性，目标和反馈，领导参与）被确定为“区分”招生达到水平的基础上，组之间的差异平均评级，考试的极端评级内的水平，和讨论的内容的主题分析。在这些结构，如组织规模和行政流程的因素;计划适合现有的组织服务和方案;招生目标的存在;和积极的领导参与实施被确定为影响程序的范围。我们的研究确定了一些有影响力的CFIR结构及其对国家DPP实施范围的影响。可以利用这些调查结果来改善招聘和协助交付组织的工作，以扩大国家DPP以及其他循证干预措施的覆盖面和规模。在线版本包含补充材料，可通过10.1186/s43058-022-00350-x获得。
Scaling evidence-based interventions are key to impacting population health. The National DPP lifestyle change program is one such intervention that has been scaled across the USA over the past 20 years; however, enrollment is an ongoing challenge. Furthermore, little is known about which organizations are most successful with program delivery, enrollment, and scaling. This study aims to understand more about the internal and external organization factors that impact program implementation and reach. Between August 2020 and January 2021, data were collected through semi-structured key informant interviews with 30 National DPP delivery organization implementers. This study uses a qualitative cross-case construct rating methodology to assess which Consolidated Framework for Implementation Research (CFIR) inner and outer setting constructs contributed (both in valence and magnitude) to the organization’s current level of implementation reach (measured by average participant enrollment per year). A construct by case matrix was created with ratings for each CFIR construct by interviewee and grouped by implementation reach level. Across the 16 inner and outer setting constructs and subconstructs, the interviewees with greater enrollment per year provided stronger and more positive examples related to implementation and enrollment of the program, while the lower reach groups reported stronger and more negative examples across rated constructs. Four inner setting constructs/subconstructs (structural characteristics, compatibility, goals and feedback, and leadership engagement) were identified as “distinguishing” between enrollment reach levels based on the difference between groups by average rating, the examination of the number of extreme ratings within levels, and the thematic analysis of the content discussed. Within these constructs, factors such as organization size and administrative processes; program fit with existing organization services and programs; the presence of enrollment goals; and active leadership involvement in implementation were identified as influencing program reach. Our study identified a number of influential CFIR constructs and their impact on National DPP implementation reach. These findings can be leveraged to improve efforts in recruiting and assisting delivery organizations to increase the reach and scale of the National DPP as well as other evidence-based interventions. The online version contains supplementary material available at 10.1186/s43058-022-00350-x.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
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作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
--
作者：
Bastos de Carvalho A;Lee Ware S;Belcher T;Mehmeti F;Higgins EB;Sprang R;Williams C;Studts JL;Studts CR
通讯作者：
Studts CR
影响因子：
--
作者：
Dorsey, Caitlin N.;Mettert, Kayne D.;Puspitasari, Ajeng J.;Damschroder, Laura J.;Lewis, Cara C.
通讯作者：
Lewis, Cara C.
影响因子：
16.2
作者：
Ackermann RT
通讯作者：
Ackermann RT
影响因子：
13.8
作者：
Ali, Mohammed K.;Bullard, Kai McKeever;Gregg, Edward W.
通讯作者：
Gregg, Edward W.