Lisa D. DiMartino, Sarah A. Birken, Laura C. Hanson, Justin G. Trogdon, Alecia S. Clary, Morris Weinberger, Katherine Reeder-Hayes, & Bryan J. Weiner
University of Washington affiliated authors are displayed in bold.
Published: March 2018
Arianna Rubin Means, Sitara S. R. Ajjampur, Robin Bailey, Katya Galactionova, Marie-Claire Gwayi-Chore, Katherine Halliday, Moudachirou Ibikounle, Sanjay Juvekar, Khumbo Kalua, Gagandeep Kang, Pallavi Lele, Adrian J. F. Luty, Rachel Pullan, Rajiv Sarkar, Fabian Schär, Fabrizio Tediosi, Bryan J. Weiner, Elodie Yard, & Judd Walson, on behalf of the DeWorm3 Implementation Science Team
University of Washington affiliated authors are displayed in bold.
Published: January 2018
[ABSTRACT TEXT]
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Virginia Wang, Matthew L. Maciejewski, Christian D. Helfrich, Bryan J. Weiner
University of Washington affiliated authors are displayed in bold.
Published: December 2017
Lisa D. DiMartino, Bryan J. Weiner, Laura C. Hanson, Morris Weinberger, Sarah A. Birken, Katherine Reeder-Hayes, Justin G. Trogdon
University of Washington affiliated authors are displayed in bold.
Published: December 2017
Byron J. Powell, Cameo F. Stanick, Heather M. Halko, Caitlin N. Dorsey, Bryan J. Weiner, Melanie A. Barwick, Laura J. Damschroder, Michel Wensing, Luke Wolfenden, and Cara C. Lewis
University of Washington affiliated authors are displayed in bold.
Published: October 2017
Advancing implementation research and practice requires valid and reliable measures of implementation determinants, mechanisms, processes, strategies, and outcomes. However, researchers and implementation stakeholders are unlikely to use measures if they are not also pragmatic. The purpose of this study was to establish a stakeholder-driven conceptualization of the domains that comprise the pragmatic measure construct. It built upon a systematic review of the literature and semi-structured stakeholder interviews that generated 47 criteria for pragmatic measures, and aimed to further refine that set of criteria by identifying conceptually distinct categories of the pragmatic measure construct and providing quantitative ratings of the criteria’s clarity and importance.
Twenty-four stakeholders with expertise in implementation practice completed a concept mapping activity wherein they organized the initial list of 47 criteria into conceptually distinct categories and rated their clarity and importance. Multidimensional scaling, hierarchical cluster analysis, and descriptive statistics were used to analyze the data.
The 47 criteria were meaningfully grouped into four distinct categories: (1) acceptable, (2) compatible, (3) easy, and (4) useful. Average ratings of clarity and importance at the category and individual criteria level will be presented.
This study advances the field of implementation science and practice by providing clear and conceptually distinct domains of the pragmatic measure construct. Next steps will include a Delphi process to develop consensus on the most important criteria and the development of quantifiable pragmatic rating criteria that can be used to assess measures.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Aaron R. Lyon, Elizabeth Connors, Amanda Jensen-Doss, Sara J. Landes, Cara C. Lewis, Bryce D. McLeod, Christopher Rutt, Cameo Stanick, Bryan J. Weiner
University of Washington affiliated authors are displayed in bold.
Published: September 2017
Bryan J. Weiner, Cara C. Lewis, Cameo Stanick, Byron J. Powell, Caitlin N. Dorsey, Alecia S. Clary, Marcella H. Boynton and Heather Halko
University of Washington affiliated authors are displayed in bold.
Published: August 2017
Implementation outcome measures are essential for monitoring and evaluating the success of implementation efforts. Yet, currently available measures lack conceptual clarity and have largely unknown reliability and validity. This study developed and psychometrically assessed three new measures: the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM).
Thirty-six implementation scientists and 27 mental health professionals assigned 31 items to the constructs and rated their confidence in their assignments. The Wilcoxon one-sample signed rank test was used to assess substantive and discriminant content validity. Exploratory and confirmatory factor analysis (EFA and CFA) and Cronbach alphas were used to assess the validity of the conceptual model. Three hundred twenty-six mental health counselors read one of six randomly assigned vignettes depicting a therapist contemplating adopting an evidence-based practice (EBP). Participants used 15 items to rate the therapist’s perceptions of the acceptability, appropriateness, and feasibility of adopting the EBP. CFA and Cronbach alphas were used to refine the scales, assess structural validity, and assess reliability. Analysis of variance (ANOVA) was used to assess known-groups validity. Finally, half of the counselors were randomly assigned to receive the same vignette and the other half the opposite vignette; and all were asked to re-rate acceptability, appropriateness, and feasibility. Pearson correlation coefficients were used to assess test-retest reliability and linear regression to assess sensitivity to change.
All but five items exhibited substantive and discriminant content validity. A trimmed CFA with five items per construct exhibited acceptable model fit (CFI = 0.98, RMSEA = 0.08) and high factor loadings (0.79 to 0.94). The alphas for 5-item scales were between 0.87 and 0.89. Scale refinement based on measure-specific CFAs and Cronbach alphas using vignette data produced 4-item scales (α’s from 0.85 to 0.91). A three-factor CFA exhibited acceptable fit (CFI = 0.96, RMSEA = 0.08) and high factor loadings (0.75 to 0.89), indicating structural validity. ANOVA showed significant main effects, indicating known-groups validity. Test-retest reliability coefficients ranged from 0.73 to 0.88. Regression analysis indicated each measure was sensitive to change in both directions.
The AIM, IAM, and FIM demonstrate promising psychometric properties. Predictive validity assessment is planned.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Bryan J. Weiner, Catherine L. Rohweder, Jennifer E. Scott; Randall Teal, Alecia Slade, Allison M. Deal, Naima Jihad, & Marti Wolf
University of Washington affiliated authors are displayed in bold.
Published: August 2017
Practice facilitation involves trained individuals working with practice staff to conduct quality improvement activities and support delivery of evidence-based clinical services. We examined the feasibility of using practice facilitation to assist federally qualified health centers (FQHCs) to increase colorectal cancer screening rates in North Carolina.
The intervention consisted of 12 months of facilitation in 3 FQHCs. We conducted chart audits to obtain data on changes in documented recommendation for colorectal cancer screening and completed screening. Key informant interviews provided qualitative data on barriers to and facilitators of implementing office systems.
Overall, the percentage of eligible patients with a documented colorectal cancer screening recommendation increased from 15% to 29% (P < .001). The percentage of patients up to date with colorectal cancer screening rose from 23% to 34% (P = .03). Key informants in all 3 clinics said the implementation support from the practice facilitator was critical for initiating or improving office systems and that modifying the electronic medical record was the biggest challenge and most time-consuming aspect of implementing office systems changes. Other barriers were staff turnover and reluctance on the part of local gastroenterology practices to perform free or low-cost diagnostic colonoscopies for uninsured or underinsured patients.
Practice facilitation is a feasible, acceptable, and promising approach for supporting universal colorectal cancer screening in FQHCs. A larger-scale study is warranted.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Racquel E. Kohler, Satish Gopal, Clara N. Lee, Bryan J. Weiner, Bryce B. Reeve, and Stephanie B. Wheeler
University of Washington affiliated authors are displayed in bold.
Published: April 2017
Breast cancer is the most common female cancer in Africa and leading cause of death resulting from cancer; however, many countries lack early detection services. In Malawi, women are frequently diagnosed with large tumors after long symptomatic periods. Little is known about local cancer knowledge.
We administered a cross-sectional survey with a discrete choice experiment to a random sample in urban and rural areas of Lilongwe district. Bivariable and multivariable analyses determined factors associated with knowledge. Preference utilities for early detection interventions were estimated using a hierarchical Bayesian model in Sawtooth software.
Of 213 women recruited, fewer than half were aware of breast cancer. In multivariable analysis, electricity at home and knowing someone with cancer increased the odds of awareness. Women were more knowledgeable about symptoms than treatment or risk factors; more than 60% erroneously believed local misconceptions. Seventeen percent were aware of breast self-examination, and 20% were aware of clinical breast examination (CBE); few reported either behavior. Common barriers included not knowing where to access CBE and transportation difficulties. Discrete choice experiment results indicated the detection strategy (breast health awareness, CBE, or both) was the most important attribute of an intervention, followed by the encounter setting and travel time.
Addressing misconceptions in health messages and engaging survivors to promote early detection may help improve breast cancer knowledge in Malawi. Program designs accounting for women’s preferences should provide breast health education and CBEs in convenient settings to address transportation barriers, particularly for women with low socioeconomic position.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Kurt M. Ribisl, Maria E.Fernandez, Daniela B.Friedman, Peggy A. Hannon, Jennifer Leeman, Alexis Moore, Lindsay Olson, Marcia Ory, Betsy Risendal, Laura Sheble, Vicky M. Taylor, Rebecca S. Williams, Bryan J.Weiner
University of Washington affiliated authors are displayed in bold.
Published: March 2017