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Implementation Science at UW

Keywords: Barriers and Facilitators

✪ Training and Support Practices and Insights in the Sustainability of mHealth Implementations in Sub-Saharan Africa

Authors:

Diana Babirye & Richard Anderson

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: January 2025

Read the full text in the open access ACM Journal on Computing and Sustainable Societies

Abstract:

We conducted an interview-based study to understand the training and support practices and insights that influence sustainable implementations of mHealth projects of varying mHealth technologies. The qualitative assessment was inspired by the Consolidated Framework for Implementation Research adapted with the recommended questions for guiding the implementation of training programs. Participants in the study (N = 16) were both international and in-country researchers managing projects in sub-Saharan Africa. We chose to focus on training and support, as it is often the interface between international and in-country components of these projects. Participants agreed on the central role of training in the implementation of mHealth projects and are following best practices. There was often a division in the responsibility of training between international and in-country researchers reflecting the distinction between project management and local implementation adaptions. One of the main findings is the importance of individualized continuous retraining to make deployments robust with respect to changing conditions with technology and personnel, an aspect that has been managed a bit differently with varying mHealth technologies as presented in this article.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia

Authors:

Dabere Nigatu, Muluken Azage, Eyaya Misgan, Daniel A. Enquobahrie, Tegegn Kebebaw, Enyew Abate, Esubalew Alemneh, Mirkuzie Woldie & Tsinuel Girma

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: January 2025

Read the full text open access in the journal Health Research Policy and Systems

Abstract:

Background

The use of eHealth innovations is becoming increasingly important in improving health outcomes, especially for maternal and newborn health. However, planning and executing these innovations can be challenging due to their complex nature. To provide guidance and clarity on implementation approaches, researchers need to use implementation research (IR) tools. We conducted IR to recognize the challenges in implementing eHealth innovations in the context of maternal and newborn healthcare using the implementation research logic model (IRLM). Therefore, this paper aims to describe the practical application of IRLM to design, execute and evaluate eHealth innovations that improve maternal and newborn care in public facilities in Ethiopia.

Methods

We employed rapid review, formative assessment and process evaluation of an eHealth innovation in selected healthcare facilities serving maternal and newborn care. The eHealth innovation we developed and deployed was named ‘ADHERE’ (Antenatal Care, ChilDbirtH CarE and Postnatal CaRE), representing the continuum of maternal care. The rapid review was conducted as an initial step using the Consolidated Framework for Implementation Research (CFIR). We employed a mix of data collection methods: interview/discussion, eHealth system or document review and direct observation. Furthermore, we executed various stakeholder engagement activities: two co-creation workshops and on-site iterative discussions. We applied the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) to capture ongoing implementation learnings.

Results

We developed IRLM of the eHealth innovation implementation for three contexts: urban, peri-urban and remote public healthcare facilities. The model depicted the mechanism of interaction between implementation determinants and implementation strategies to produce the intended implementation outcomes. The IRLM helped to identify more than 35 implementation barriers or facilitators for eHealth interventions and to develop over 17 mitigation strategies for the study contexts. The initial IRLM was refined through ongoing implementation learnings and the mitigation strategies that were executed.

Conclusions

The IRLM is a comprehensive and effective guiding tool for the development, implementation and evaluation of innovations in various low- and middle-income contexts. Researchers and implementing partners should adapt and use it.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

Dissemination and Implementation – A Primer for Accelerating “Time to Translation” in Radiation Oncology

Authors:

Patricia Mae G. Santos, Sierra Silverwood, Gita Suneja, Eric C. Ford, Nikhil G. Thaker, Jamie S. Ostroff, Bryan J. Weiner, and Erin F. Gillespie

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: December 2024

Read the full text in the subscription access International Journal of Radiation Oncology - Biology - Physics

Provider Identified Access Barriers to Delivering Acupuncture to Persons with Traumatic Brain Injury and Chronic Pain: A Cross-Sectional Self-Report Survey

Authors:

Jolie N. Haun, Risa Nakase-Richardson, Jeanne M. Hoffman, Mitch Sevigny, Mark D. Sodders, Flora M. Hammond, Bridget A. Cotner, Amanda Tweed, Robin Hanks, and Aaron M. Martin

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: November 2024

Read the full text in the subscription access journal Journal of Integrative and Complementary Medicine

A Guide to Implementation Science for Phase 3 Clinical Trialists: Designing Trials for Evidence Uptake

Authors:

Harriette G.C. Van Spall, Laura Desveaux, Tracy Finch, Cara C. Lewis, George A. Mensah, Yves Rosenberg, Kavita Singh, Francois Venter, Bryan J. Weiner, Faiez Zannad

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: November 2024

Read the full text in the subscription access Journal of the American College of Cardiology

✪ Acceptability of single-dose HPV vaccination schedule among health-care professionals in Kenya: a mixed-methods study

Authors:

Grace Umutesi, Bryan J Weiner, Lynda Oluoch, Elizabeth Bukusi, Maricianah Onono, Betty Njoroge, Lucy Mecca, Kenneth Ngure, Nelly R Mugo, Ruanne V Barnabas

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: November 2024

Read the full text in the open access journal JNCI Monographs

Abstract:

Background

The World Health Organization recommends a single-dose human papillomavirus (HPV) vaccination schedule for girls and boys to accelerate progress toward cervical cancer elimination. We applied the Theoretical Framework of Acceptability (TFA) within the context of HPV vaccination to assess the acceptability of a single-dose schedule among health-care professionals in Kenya.

Methods

A REDCap survey was developed using relevant Theoretical Framework of Acceptability domains and validated with health-care professionals. Descriptive analyses and multivariate Poisson regression were conducted to assess factors associated with increased acceptability. Free-text responses were analyzed using a rapid qualitative approach, and findings were presented using a joint display.

Results

Among 385 responses, 74.2% of health-care professionals were female and 48.6% were nurses. On average, respondents had been in their position for 60 months, and one-third (33.2%) were based at level-4 facilities. The majority (75.84%) thought that giving a single-dose of the HPV vaccine to adolescent girls and young women was either acceptable or very acceptable. Qualitative findings highlighted that lack of information was the underlying reason for health-care professionals who were resistant, and most clinicians thought that a singled-dose schedule was less burdensome to clinicians and patients. Hospital directors had a non–statistically significantly lower acceptability likelihood than nurses (incident rate ratio = 0.93, 95% confidence interval = 0.45 to 1.71) and health-care professionals at urban facilities had a non–statistically significantly lower acceptability likelihood than clinicians in rural facilities (incident rate ratio = 0.97, 95% confidence interval = 0.83 to 1.13).

Conclusion

Although not statistically significant, predictors of increased acceptability provide information to tailor strategies to increase HPV vaccination coverage and accelerate progress toward cervical cancer elimination.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

Barriers and facilitators to implementing enteral resuscitation for major burn injuries: Reflections from Nepalese care providers

Authors:

Raslina Shrestha, Kajal Mehta, Aldina Mesic, Dinasha Dahanayake, Manish Yadav, Shankar Rai, Kiran Nakarmi, Pariwesh Bista, Tam Pham, & Barclay T Stewart

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: October 2024

Read the full text in the subscription access journal Burns